HomeMy WebLinkAboutDrain Layers Permit 700 Ellington Road l
= , _ OWN OF SOUTH WI N DSOR
1ar o-Ab,__-X DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut /S
DRAIN LAYER' S PERMITO 68
- , 19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at R 6 404, -,&4Z, 2M 15c.z.iyr",J -496,472elon the
L-Y JIV side, between `y` yi 4444
p
at premises owned by 440 440
whose address is ~4 Y* W
and to Lay House Drain, Repair House Drain, Lay Main, Other
for ( ewcy or use,
with Family Units, with .h } acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, STES, OR
Connection will be made with
Permit to be issued to -`
the holder of Drain Layer's License No Permit will expire one} I9,�f
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. r } and/or C H D Permit No. k
for street excavation.
SPECIAL CONDITIONS .4t740 a Cwp.06a A4.44F APP.4CMI/M.WArAV S#r X&Wr
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Signed
Connection Charge Paid $ ; ' Licensed Dra• ayef'Ar
(Sig) issued by z
Tax Collector
Permit Fee: Paid $
INSPECTION ` K #
INITIAL "'`� (Sig)
FINAL (Sig)
APPROVED ' ;' (Date)
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INSPECTOR
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