HomeMy WebLinkAboutDrain Layers Permit 718 Ellington Road -
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TOWN OF SOUTH WFN DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut ��¢
List No.: _
DRAIN LAYER'S PERMIT
p 692
Octe 23r 10, , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 718 MIIM;Wb on the
side, between
at premises owned by Atlantic 111oh old
whose address is
and to X Lay House Drain, Repair House Drain, Lay-Main, Other ,
for occupancy or use,
with Family Units, with OR* acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with 3i�O� P�lstie Pike
Permit to be issued to Mafia 1l' AM MI d1�R l OU01 Alaifiii
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 y
Connection Charge Paid Licen sed Draitr`Layer
Issued by 11� J• �th
Tax Collector
e
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Permit Fee:. Paid _
INSPECTION: Check Number:
INITIAL f- (Sig)
FINAL_ _ Si
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APPROVED (Date)
IF
(Sig)
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SPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION IS ;
OWNER
TYPE OF WORK
DATE PERMIT PIPEghgfdi,-
INSTALIEM
INSPECTOR DRAWN BY