HomeMy WebLinkAboutDrain Layers Permit 0199 Avery Street N
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE 7 PERMIT PIPE
INSTALLER
INSPECTOR jt''P DRAWN BY f
TOWN OF SOUTH WIND R
_ SO
ZIP
DEPARTMENT OF POLLUTION CONTROL -,_ -
South Windsor, Connecticut
ZdAt 41€
} z DRAIN LAYER'S PERMIT M 498
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Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ISUV" on the
%Vft side, between O SM OLftt
at premises owned by AdsSAMAW
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for ft4 occupancy or use,
with me M Family Units, with acres.
Type of Sewage to be connected under this permit:
(.SANITARY SEWAGE) INDUSTRIAL WASTES, OR
Connection will be made with 2AX01 e a Ot Sts 100ALN deva or i * Or ,.
Permit to be issued to l* ftmttygm
the holder of Drain Layer's License No. Permit will expire on I ;0M 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 f * ftneft Red b9*f1Jk1 W% *
Signed {
Connection Charge Paid Li sed rain Layer
(Sig) Issued by #
- Tax Collector
Permit Fee: Paid $. ,1.5*
INSPECTION:
INITIAL
(Sig)
r�;.�;`W Si
FINAL _ _`_; „ (Sig)
APPROVED (Date)
(Sig)
INSPECTOR