HomeMy WebLinkAboutDrain Layers Permit 369 Miller Road TOWN OF SOUTH WINDSOR
.SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 911
BUILDING ADDRESS OR LOT N° : .�
STREET:
SUBDIVISION:
0
NH STATION : +
NORTH ARROW INVERT ELEV:
TIE TIE
F T. -FT
HOUSE n
ivz_
LATERAL LATERAL HOUSE
CONNNEECTION STUB j STUB CONNECTION
FT A BUILDING INV. ELEV. INV. LEV. INV. ELEV. I ELEV. BUILDING
(IF EXIST.) t T.)
TIE TIE
Mi STATION : +
INVERT ELEV:
All-
CONTRACTOW PRINT) NAME OF CONTRACTORS SUPERVISOR(PRINT)
STREET ADDRE SIGNATURE DA E
d2l'a;�f-,�� c-T (-ywr
TOWN STATE ZIP INSPECTED BY TOWN DATE
C ,()3) , s �-
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW -CONSULTING ENGINEER/DEVELOPER