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TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut 56103 Z
List.No.: _
DRAIN LAYER"S PERMIT O 1096
1 a Yin!y , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Rovd. ( LOT 4) on the
nee':tji side, between Strei-t & Norton 1"Ine
at premises owned by iJ Tl S• �ier.4in R. & lielen 0.
whose address is same
and to Lay House Drain, Repair House Drain, Lay Main, Other ,
for asir z;l.L4 jJ_ occupancy or use,
with 1;; (i Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with SLK-11-lch (611) so1`r(-:nta io:i.nt plastic pi,,)e to I i
}.17r.141 of 1009' �
Permit to be issued to Vito
the holder of Drain Layer's License No. iO-20 5932 Permit will expire on 1 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 h �, ? -
)1^, ii �. F, l^ t:0 a r. f'o-i 7i s C. TO O C!'j t:;Ol'7
:; n`. i n ,i•,,r' ih,., ., �,-. ar^t.'i rn' i r;l�'.7n^nc wlYrl .m�
f
Signed
Connection Charge Paid O.5._1 Licensed Drain Layer
Issued by n {yin 1,;dwa.rds, J.
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED -z 114AJ. 19?4 (Date)
(Sig)
INS 9CTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
Drawing not to scale. LOCATION 12 Beelzebub Road
OWNER WENZ Merwin R. & Helen 0.
TYPE OF WORK Hou§e coZMrction
DATE 5-25-76 PERMIT 1096 PIPEr. " so�v,
INSTALLER Vito (W -20 24)
INSPECTOR DRAWN BY AL
,. 1 .7
411z'
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 in Formation such as driveways, large trees
and other obstructions, -
PLEASE MAIL THIS FORM IMMEDIATELY TO:
JAMES S. MINGES & ASSOC., INC.
The Exchange
Farmington Avenue
Farmington, Connecticut 06032
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