HomeMy WebLinkAboutDrain Layers Permit 1708 Ellington Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut --�
List No.: _ Lry �5
DRAIN LAYER'S PERMIT N? 2165
19
Pursuant to written applicatior, permission/.s/fhereby ranted to the Licensed Drain Layer named herein to perform
the work indicated below at 176 on the
side, betwee
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 ( ), 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 sweet excavation.
r/ ,\
SPECIAL CONDITIONS e6 4�-' Al e/ C'
060 -
/ 0 Signed
Connection Charge
Paid Licensed Drain er
Issued by
Tax Collector l&s
oG
Permit Fee: Paid V$ -1
�S_
INSPECTION: Check Number: 3 3�
INITIAL (Sig)
FINAL (Sig) we�J
APPROVED (Date)
(Sig)
INSPECTOR
t
,
o
NOTES SOUTH WINDSOR POLLUTION COBTROL
LOCATION 170Y
OWNER
TYPE OF WORK St ,S'
DATE ' PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY