HomeMy WebLinkAboutDrain Layers Permit 1744 Ellington Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: � `� 2-,
DRAIN LAYER'S PERMIT Np 1620
2 - Z7 , 19�
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between ����/`�S � Aj(/{7jly
at premises owned by /YI L G• / -/� �Z
whose address is _ 1 74-4 o �/A
and to �/ Lay House Drain, Repair House Drain, Lay Main, Other
for _ occupancy or use,
with Family Units, with acres.
Type of Sewage to bee nnected under this permit:
SANITARY SEWAGE ( )� , INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to. G
the holder of Drain Layer's License No. 'Z U�i�7,�`J�1 Permit will expire on l 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
( � 061 Signed
n", Lo 'j-4t
Connection Charge Paid 1-1115�-v Licensed Drain Layer
Issued by
Tax Collector �
Permit Fee: Paid $ ____Ietaq—�
INSPECTION: Check Number: =�-2 51
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 4-- _
OWNER l_ t 5� l_"-,l L
TYPE OF WORK i " -EA , e- f l
DATE - - 7 PERMIT fc '�..0 PIPE
INSTALLER 4 a,4,t,( '/ >
I INSPECTOR= ` ' _ �� WN BY /-,
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