HomeMy WebLinkAboutDrain Layers Permit 1720 Ellington Road TOWN OF SOUTH WI N DSOR
DEPARTMENT_ OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT NO 2166
f�- , 19 O!/
Pursuant to written application, permission is hereby gra ted to the Licensed Drain Layer named herein to perform
the work indicated below at .1 Z2 on the
side, betwee
at premises owned
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 street excavation.
SPECIAL CONDITIONS t!'o 1-10 C A. rC- -t'
Signed
Connection C rge Paid � � Licensed Dr Layer
Issued by `
Tax Cesar
Permit Fee: Paid $ 4:�______
INSPECTION: Check Number: 353�
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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10
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER \IJ
TYPE OF WORK
DATE U PERMIT PIPE f-%)c
INSTALLER C
INSPECTOR `�' r DRAWN BY l C'.
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