HomeMy WebLinkAboutDrain Layers Permit 2735 Ellington Road " TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
Z
List.No.: _
DRAIN LAYER'-S PERMIT 1484
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Zer �
,55 E -I NG I ' �®/�,� on the
side, between
at premises owned by
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 O INDUSTRIAL WASTES .( ), OR, ( ,)
Connection will be made with
Permit to be issued to 41422 M is I
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
n�/� Signed
Connection Charge Paid tic 7 License Drain Layer
f+1 4 -7f Issued by _V
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: ry
INITIAL (Sig)
FINAL (Sig)
APPROVED -7 (Date)
INS CT (Sig)
N j
I
�I
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 2135 ELLiNGTON ROAD
OWNER -FRO-TT
TYPE OF WORK kou 0NNF-::C--FlQt\/
DATE -l(o-'18 PERMIT I �y PIPE &" P.V.C
INSTALLER A.
INSPECTOR GT, DRAWN BY 0, K