HomeMy WebLinkAboutDrain Layers Permit 69 Deepwood Drive TOWN OF -SOUTH WIN[ SOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
� �
` List.No.: _ �=
DRAIN LAYER'S PERMIT Np 807
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 69 " ( L ¢® on the
side, between
at premises owned by SUM h8U8*
whose address is SMi
and to X Lay House Drain, Repair House Drain, Lay-Main, Other
for Itpfiltditia - occupancy or use,
with 0190 Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( X), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with SJ X "'1Ich Plastic Pipe
Permit to be issued to tto"Ph PtquottX
the holder of Drain Layer's lcense No. 't�, Permit will expire on 19
The undersigned Drain Layc`r hereby agrees to alf th terms and conditions set forth on the permit and the reverse side
the Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
/� Signed
Connection Charge Paid 3� /-/' Licensed Drain ater
' ftith
Issued by ��'�� t
Tax Collector
�f
Permit Fee:`Paid $
INSPECTION: Check Number: ,
INITIAL (Sig)
FINAL , (Sig)
APPROVED 7CfI'T f✓ (Date)
f r—. (Sig)`
r
To help locate your sewer connection on-the main line, please show
+ where you would like the connection by drawing 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 on-sketch. ._IF.you have any doubt please contact
the Town Engineering::Department.
Please draw important in Formation such as driveways, large trees
and other obstructions. . .
PLEASE MA11L THIS FORM IMMEDIATELY TO:
JAMES S. MINGES & ASSOC. , INC.
The Exchange. :
Farmington Avenue
Farmington, Cor)necti:cut. 06032
N 407
i �
Ya 61
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