HomeMy WebLinkAboutDrain Layers Permit 0142 Avery Street `2 N_ '
TOWN OF SOUTH W1 N DSORT y 4 ,�q
a _ DEPARTMENT OF POLLUTION CONTROL
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South Windsor, Connectecut
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DRAIN LAYER'S . PERMITO 4►72_ x
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"- Pursuant to wtitten applicati%on, permission is hereby granted to th&Licensed Drain Layer named herein to perform
the work indicated below at 4 4P IN% -�er �'1�iG�1�81tEV% �iOlLrf. � ` on the
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side,-be(�t♦(w}ee�7n
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at premises owned by $ . = � _ :,, .
whose address is ,
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and to i Lay House Drain, Repair House Drain, Lay,Main, ` Other = x
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for l'� Ir F occupancy or`use- .
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with n � Family Units, with ` - .. acres
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-Type of Sewage to be.connected under this permit 4 .- _ x , , ,I
SANITARY SEWAGE}, INDUSTRIAL WASTES, OR = YY
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FConnectton will be madfe with F3X #Q1 .8t3 - $ � # x
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Permit to be issued'to ! t - -
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the holder of Drain Layer's` License 14 W � Permit will,exp re onj)�� 9 19�+' ""
s The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the.permit and the reverse side � ,�
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thereof Applicant has received Town Permit No and/or C H D Permit No # '
for street excavation. }7 m.�4��:-,-,�
SPECIAL CONDITIONS x l
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• Connection Charge Paid $16/10l7 - Licensed Drain Layer. : x
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(Sig) Issued by h•A*I i ikwo thri t rl n
Tax Collector
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Permit Fee: Paid l% -
INSPECTION: - �'i1 i*` 1 88
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INITIAL' { �J , "�C/7 / GfI (Sig)
FINAL / r / // ;3a �/7 (Sig)
APPROVED / �'' (Date)
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V' INSPECTOR . -
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LE�h/ Ol�fi /9T�A /�x;0 LOCATION /4 v i,
OWNER
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DATE c4 2 4 ZrPERMIT PIPE
INSTALLER L v,
INSPECTOR Xf DRAWN BY Ff X