HomeMy WebLinkAboutDrain Layers Permit 2825 Ellington Road �. 4
TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER"S PERMIT NO 1486
-21 ' 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at j3 , on the
side, between �^
at premises owned by F o�n1,
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for Pt)den�y a occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit: ...�
or 7i.r
SANITARY SEWAGE.(L/,', INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with 0
Permit to be issued to ,I d C rv.�zi 2 1 S n pi,Y s k o`
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 ensed Drain Layer
G+
Tax Collector Issued by
Permit Fee: Paid $ , ov
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
IV
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19 �
E ,L.I NGM0 N Rote
NOTES SOUTH WINDSOR POLLUTION CONTROL
Pi{ Covescec) LOCATION 2825 Gling on Pc)cAJ
y
OWNER Rnkle.
TYPE OF WORK 4ovs-- Conec. ion
DATE 8/2i/"t R PERMIT I H 8 G PIPE
INSTALLER
INSPECTOR D.L. DRAWN BY C.K.