HomeMy WebLinkAboutDrain Layers Permit 827 Ellington Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut T
List No.. Z)' ,i C
DRAIN LAYER'S PERMIT No 1099
, 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at t Fad- 7;34 r 3rtn t
on the
side, between {',rt,y...m; i
at premises owned by =
whose address is
and to Lay 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 (:,x ), INDUSTRIAL WASTES _( ), OR
Connection will be made with
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 Paid Licensed Drain Layer
Issued by ,
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: ,
INITIAL (Sig)
FINAL (Sig)
APPROVED '�� °> t 9` (Date)
9
(Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
Drawing not to scale. LOCATION 827 Ellington Road
OWNER RDGERS Robert L. & Viol
TYPE OF WORK Houge Coanection
DATE PERMIT . 1099 PIPE
INSTALLER Vito (W -20 24)
INSPECTOR DRAWN BY