HomeMy WebLinkAboutDrain Layers Permit 1331 Ellington Road w:
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut P
List.No.: (�
DRAIN LAYER'S PERMIT NO 1809
S , 19 77
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to-perform
the work indicated below at 3 3 / l/�^ 52 on the
side, between at premises owned by (%4/1/a WX Q / i
•
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 ( ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with
Permit to be issued to Ale-5 h i C &V ,
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
L)Ate i-Al-� Signed
Connection Charge Paid Licensed Drain Layer
- Issued by •�
Tax Collector �l Ul 7f
Permit Fee:. Paid/$ �s G60 _
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED - ��// (Date)
y/�✓X,��c w (Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION /( d
OWNER Pr a,� G. i 1--
TYPE OF WORK
DATE PERMIT /£s0 9 PIPE G" P(��
INSTALLER
INSPECTOR DRAWN BY