HomeMy WebLinkAboutDrain Layers Permit 41 Beelzebub Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.: _
South Windsor, Connecticut
List No.: 71
_
DRAIN . LAYER'S PERMIT N? 2974
19�
Pursuant to written applicatior permission is herel�jgrante to the Licensed Drain Layer named herein to perform
the work indicated below at / ,(y on the
side,between
at premises owned by 0. w
whose address is
and to Lay House Drain, Repair House Drain, Lay'Main, Other
for
occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, INDUSTRIAL WASTES .( ), OR
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on 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
r
-' 1t Issued by
ax Collector
Permit Fee: Paid $ _4 v
INSPECTION: Check Number:
INITIALL�� "
(Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
"sf N
To help locate connection your sevver 'y �n on the main line, please show
'where you would like the connection by dravving a line from the house or
the septic tank to the main line in the street. Also, install stake in yard
to indicate line as shown o.n sketch. If.you have- any doubt please contact
the Town Engineering Depar ment,
Please draw important in Formation such as driveways, large trees
and other obstructions.
PLEASE MAIL THIS FORM IMM`DIATELY TO:
JAMES S. MINCES ASSOC. , INC.
The Exchange
Farmington Avenue
Farmington, Connecticut 06032)
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___11r. e,.�Ma:'s F. Donald zrlcLaughlin
f7 ' iie )71b iioad LaT 2
South Windsor,, Connecticut