HomeMy WebLinkAboutDrain Layers Permit 2089 Ellington Road TOWN OF SOUTH WINDSOR
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DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List,No.:
DRAIN LAYER'S PERMIT
O 646
e ; 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Im ru Balkd on the
side, between
at premises owned by AVOW to A00091
whose address is
-
and to Lay House Drain, Repair House Drain, Lay-Main, Other ,
for al _ occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (11), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with INX ,
Permit to be issued to J06K Aw
the bolder 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 e
Connection Charge Paid Licensed Drain Layer —
Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL yN. (Sig)
FINAL (Sig)
APPROVED ' �`;
, ��,�� (Date)
a3 (Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK c
DATE 'PERMIT PIPE . .
INSTA LE
INSPECTOR F` . DRAWN BY ,,'... '
To help locate your se�nier 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 tine 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 information such as driveways, Iarge trees
and other obstructions. -
PLEASE MAIL THIS FOPM IMMEDIATELY TO:
JAMES S. MINCES & ASSOC. . I1\1C.
The Exchange
Farmington Avenue r
Farmington, Connecticut 06032
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