HomeMy WebLinkAboutDrain Layers Permit 0271 Avery Street �---- TOWN OF,, SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
s �__._ South Win
dsor, Connecticut
�j DRAIN LAYER' S PERMIT rfi:6°19357
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2 AU9 , 19 73
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 271 Avery on the
side, between. Ur &B taAiet
E
at premises owned
whose address is
and to X Lay House Drain, Repair House Drain, Lay Main, Other ,
fori �2, occupancy or use,
with 0" ` ) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with aim JuA& (6) Aa&U&
Permit to be issued to J*hAA* X
the holder of Drain Layer's License No-W 1W Permit will expire on 2n. 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 PrOU 14"t to p s orw& nd bad' U mit#s bank
z, f
Signed .fit _ fiJ i
Connection Charge Paid 1-" Licensed Drain layer
Por X No"s (Sig) Issued by pk a�• 1il"t ltlt r Jr*
Tax Collector
Permit Fee: Paid $ i
INSP CTION: Ck eek 1
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPIfft0k
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A
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER Fe4l-4
TYPE OF WORK 5F'kJ 6,e
DATE - o 2 PERMIT :7-3 PIPE
INSTALLER fJ n d4
INSPECTOR DRAWN BY ?,r