HomeMy WebLinkAboutDrain Layers Permit 15 Beelzebub Road ej
r s. TOWN OF SOUTH WI N DSOR .� ,s
DEPARTMENT OF POLLUTION 'CONTROL ' gip No.: _
South Windsor, Connecticut. '
S;
List No.:
DRAIN LAYER"S PERMIT �O 697
119
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at _ on the
side
W 1111161" at premises owned by V& 6 Aft So
whose address is
and to Lay'House Drain, Repair House Drain, 1.ay-Main, Other
-for Pam& occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with�� � �� � � 0 WNW& was so#%W. g
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on :dfl ' 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed _:... .
Connection Charge Paid Licensed Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $ _
INSPECTION: Check Number.
INITIAL Lc:�L" " ,g _ (Sig)
FINAL (Sig)
APPROVED »- :x'1 �,4 +" _;�r, ' (Date)
(Sig)
INSPECTOR
J
61 �2
01
ti
-�0/1171411
To help locate your sewer connection on the main line, please show
'✓,'Clere you would IiE<e the connection by drawing a line From the house or
the septic tank to the main Iine in the street. Also, install stake in yard
to indicate line as shown on sketch. . If-you have any doubt please contact
!_he
Town Engineering Department.
Please draw important information Such as driveways, large trees
and other obstructions.
PLEASE MAIL THIS FORM Wuvi`.DiATE—Y i O:
JAIV1ES S. 1V1ING"S & ASSOC. , INC.
The Exchange
Farmington Avenue
Farmington, Connecticut 06032
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