HomeMy WebLinkAboutDrain Layers Permit 1678 Ellington Road TOWN OF SOUTH W 1 N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut ��, � 7
� List.No.: � lC�
DRAIN LAYER"S PERMIT NO 1837
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to"perform
the work indicated below at/ A0 7 on the
�/ c
Y_Q�zside, between
at premises owned by u/ `
whose address is '1 6 7
and to Lay House Drain, Repair House Drain, Lay-Main, Other � �z
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be c nnected under this permit:
SANITARY SEWAGE ( 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 ter verse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation. r
SPECIAL C NDITIONS
` h
Signed Criy►n ��(f�ii.
;Con4nectiarge Paid �'�� LicensedIssued by
tor
Permit Fee: Paid $
INSPECTION: Check Number: 7" /
INITIAL (Sig)
FINAL (Sig)
APPROVED �� Z S _ /�av7r (Date)
INSPECTOR (Sig)
1
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