HomeMy WebLinkAboutDrain Layers Permit 2083 Ellington Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 2539
19 F z
Pursuant to written applti�catioor, permission is hereby granted to the Licensed Drain Layer named herein to perfor
the work indicated below at O�68 �k L� � ,^ �� on the
side, between
at premises owned by Aj
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 ( ), 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 theterms 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
�a �9 Signed
4nnectilon,Charge Paid Licensed Drain Layer
Issued by
lector
^ Permit Fee:. Paid
INSPECTIO • Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR