HomeMy WebLinkAboutDrain Layers Permit 2743 Ellington Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER'S PERMIT N° 2570
19
Pursuant to written applicati/or, permission is hereb rante o the Licensed Drain Layer named herein to perform
the work indicated below at o2 on the
side, betwee
at premises owned by
whose address is
and to —ZfLay 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 ( J, INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with
Permit to be issued to %/
the holder of Drain Layer's License No. f/ L J� `/ ® Permit will expire on_ 1 j,2 1ge
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
Sign iAceh
Connection Charge Paid (J�, ed Drain Layer
aaj" Issued by
Tax Collector ��-
Permit Fee: Paid $ 2.
INSPECTION: Check Numbers &t�
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR