HomeMy WebLinkAboutDrain Layers Permit 2233 Ellington Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMIT NO 1285
, 19
Pursuant to written applicatior, permissi n is her y grant e o t e Licensed Drain Layer named herein to perform
the work indicated below at �d3 /// /Q-U on the
side, betty/el'
—at rem s owned by 9
(/ e
whose addr s is U' �—
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for V occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( INDUSTRIAL W TEAS
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 ensed Drain Layer
P2 V Issued by
Tax Collector
Permit Fee:. Paid $ /S ®0
INSPECTION: Check Number: , 24r=> �J
INITIAL (Sig)
FINAL (Sig)
APPROVED / (Date)
(Sig)
INSPECTPA
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NOTES SOUTH WINDSOR POLLUTION CONTROL.
LOCATIO 2z 3 3 - /�?
OWNER
TYPE OF WORK U
DAT - - RMIT PIPE
INSTALLER
INSPECTOR DRAWN BY