HomeMy WebLinkAboutDrain Layers Permit 673 Ellington Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT *t
19— —
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 3 U21MOM %ad on the
u side, P ' 3► us s at premises owned by _ i t r, e
whose address is
and to XX_Lay House Drain, Repair House Drain, Lay Main, Other
for " occupancy or use,
with � i Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, SK INDUSTRIAL WASTES, OR
Connection will be mad "
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 Pai ., Licensed Drain Layer
V" 9s VNIM A (Sig) issued by- l U-i?I y *
Tax Collector
Permit Fee: Paid
INSPECTION:
INITIAL (Sig)
FINAL ._ (Sig)
APPROVED (Date)
.. .� (Sig)
I PECTOR
,Lata Truckin 1311 ELUNGTON RD., SO, WINDSOR, CONN. 06074
ST. FRANCIS OF ASSISI CHURCH
G-)3 ELLINGTON ROAD
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