HomeMy WebLinkAboutDrain Layers Permit 033 Ash Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut S4cEOdZ
.._.._.. List.No.: _
DRAIN LAYER' S PERMIT N? 1103
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layel named herein to perform
the work indicated below at F on the
side, between
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 ( )
I(Connection will be made with ' i�Qtii r
Permit to be issued to ;
the holder of Drain Layer's License No. Permit will expire on CGu19��
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 nn'
Signed
Connection Charge Paid Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION• Check Number:
(SigZ - -
FINAL (Sig)
APPROVED ol Jcw6 19?6 (Date)
(Sig)
INSPECTOR
J
All
N
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE PERMIT PIPE
- -- - - - ---INSTALLER-- -
INSPECTOR DRAWN BY
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To help locate your sewer connection on-the main line, please show -
where you would like the connection by drawing a line from the house or
the septic tank to the main line in the street. -Also, install stake in'yard
to indicate line as,shown on sketch. . IF.you have any doubt please.contact
the Town Engineering Department.
Please draw important information such as driveways, large trees
and other obstructions. -
PLEASE MAIL THIS FORM IMMEDIATELY TO:
JAMES S. MINGES & ASSOC. , INC.
The Exchan9e
Farmington Avenue
Farmington,. Connecticut 06032
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