HomeMy WebLinkAboutDrain Layers Permit 2340 Ellington Road ti TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut 2
List.No..
DRAIN LAYER'S PERMIT NO i268
---, 192Z
Pursuant to written applicatio , permission is hereby grant d to the icensed'Draig Layer named herein to perform`
the work indicate ow at 7� Z 3� on the
side., between
at premises owned byclozeezo;y-if Zell
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 ,BASTE y� OR ( )
Connection will be made with (/t
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 Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $ Q
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED �7 (Date)
(Sig)
INSPECTOK
Si
e,
V7
NOTES SOUTH WINDSOR POLLUTION CONT L
LOCATION 2 3 O ail
OWNER �" r G."` Gi�f;'
TYPE OF WORK
DATE 7- PERM PIPE
INSTALLER
INSPECTOR DAAWN BY
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f
f
i
er
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.W• p
TOWN OF SOUTH WINDSOR
TOWN HALL
.SOUTH WINDSOR, CONN. 06074
DEPARTMENT POLLUTION CONTROL
- Z s?.
Date . . . . . . . . . . . . .
The Sanitary Sewer . . . Septic System ... . . . . ._. . .
at
. . . . . .0 .1012 .
� 4 . . . .
9 .
or lot #. . . ..5 . . . . . . . . as been installed and completed
in accordance with the Town of South Windsor ordinances
and regulations.
Accepted Approved
By Date