HomeMy WebLinkAboutDrain Layers Permit 0246 Avery Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL c�
South Windsor, Connecticut
DRAIN LAYER'S PERMIT N? 492
NMI, 11923
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at A6 AMM S46 on the
side, between ;
at premises owned by Ad= &SOW,pA
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for 1r13 I occupancy or use,
with am W Family Units, with acres.
Type of Sewage to be connected under this permit:
(SANITARY SEWAGE) INDUSTRIAL WASTES, OR
Connection will be made with akl too 2148"Al
Permiti<'to be issued to Y11
z
the holder of Drain Layer's License No. " Pernxit will expire on ISU5 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 ? ' so
as Mho mid hulkj= moms took
ems.
Signed—
Connection Charge Paid $ R License Drain ppe-
P"
F°
IL (Sig) Issued by llk As l Mlt site
Tax Collector
Permit Fee: Paid $
INSPECTION:
INITIAL >_; (Sig)
FINALR' (Sig)
APPROVED .r (Date)
(Sig)
INSPECTOR
1
� � r
� 3
/2
i
1
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION zlG ,
OWNER
TYPE OF WORK jF Z-)7,1:
DA PERMIT 9 2 PIPE
INSTALLER z'. i
INSPECTOR DRAWN BY
l /2-/'7l 7(.