HomeMy WebLinkAboutDrain Layers Permit 1519 Ellington Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut �. ( 9
List.No.: _�L
DRAIN LAYER'-S PERMIT NO 1662
, 19 7�'
Pursuant to written applicatior, permission is hereby, ted to the Licensed Dr 'n Layer named herein to perform
the work indicated halo at l! on the
C
side, between '
at premises owned by
whose address is
and to —LLLay House Drain, Repair House Drain, Lay Main, Other,
for occupancy or use,
with efl-)42-Family Units, with acres.
Type of Sewage t;INDUSTRIAL
co nected under this permit:
SANITARY SEWAGE ( WASTES .( ), OR ( )
Connection will be made with 1,2 Itl
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 1 Zp 1979 Licensed Drain Layer
AczZS / �-
Issued by
Tax Collector
Permit Fee:. Paid $ _ 1 S! o o
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INS CTO (Sig)
v
G
f-0 67'i^le.1
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S1r
APT
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION t
OWNER
TYPE OF WORK 5
DATE 4- 2 _ PERMIT PIPE
INSTALLER 4 C-L p
INSPECTOR A _ RAWN BY