HomeMy WebLinkAboutDrain Layers Permit 2362 Ellington Road TOWN OF SOUTH WI N DSORE-k s_
DEPARTMENT OF POLLUTION CONTROL B/P No.:
r # South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT
N° '724
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at P7 c,' naldlkOAM 516M on the
+clan* side, between 0r'tye m,.d Tomter St"et
at premises owned
whose address is 0-fl�4
and to Lay House Drain, Repair House Drain, Lay-Main, Other
font , "! occupancy or use,
with— Q ( Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (t!R), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Si t1 ;try } �¢
Jimz b ir 9#51;s
Permit to be issued to To%n A# r an
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 rf
Connection Charge Paid Licensed Drain Layer
4 Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED-1 (Date)
(Sig)
INSPECTOR
N
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE %/' PERMIT " , PIPE ,
INSTALLER
INSPECTOR DRAWN BY
9-6
t
r' d
To help locate your sewer connection on the main line, please show
where yp.,j 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. I F.you have any doubt please contact
the Town Engineering Department,
Please draw important information such as drivevvays, large trees
and other obstructions.
PLEASE IMAiL TIHIS FORM IMMEDIATELY TO:
JAiViE S S . /v;INGES & ASSOC. , INC_
The Exchange
Farmington Avenue
Farmington, Connecticut 06032
it
17
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