HomeMy WebLinkAboutDrain Layers Permit Ellington Road/Clark TOWN OF ,. SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
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DATE OF CONSTRUCTION:
BUILDING ADDRESS OR LOT N' : `��o"
�> STREET: L.. I r I/� s ,
SUBDIVISION:
Mi STATION : �.Lf
NORTH ARROW INVERT ELEV:
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F T -FT
HOUSE _ LATERAL -E.RAL-,-/� r_ HOUSE
CONNECTION # STUB STUB CONNECTION
FT. I FT
BUILDING INV. ELEV. INV.ELEV. INV. ELEV. I ELEV.(IF BUILDING
Lr EXIST.)
(IF EXIST.)
CA
TIE TIE
Cv� /
W STATION :/6 #lL,
'2 ., a INVERT ELEV:
CONTRACTOR (PRINT) NAME OF CONTRACTORS SUPERVISOR(PRINT)
1...- v c' 1 C(' \_ `l} 41.1�(.
STREET ADDRESS SIGNATURE DATE
— N
TOWN f STATE ZIP INSPECTED BY TOWN DATE
TELEPHONE NUMBER
VHITE TOWN PINK - CONTRACTOR YELLOW -CONSULTING ENGI
rNEER/DEVELOPER
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