HomeMy WebLinkAboutDrain Layers Permit 0300 Avery Street Y ' ` TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.: *�
South Windsor, Connecticut
" List.No.: _S e..o'T/q
DRAIN LAYER'S PERMIT
p 1015
' 19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 3M 8�1'rpe+ C L67 on the
gmat side; between AgA t thdIye. "d Ma �+ss�<`�.. ' wrl I '
at:premises"owned by - q4 LF �"e A t Sk Ke
whose address is pis
and to Z_Lay House Drain, Repair House Drain, Lay Main, Other
for £dl occupancy or use,
with Family Unirs, with acres.
Type of Sewage to be connected under this.permit:
SANITARY SEWAGE O, INDUSTRIAL WASTES .( ), OR
Connection will be made with gu9Y,..ach (fi") 3d gj&t. # At a_
of 93t+G
Permit to be issued to-
the holder of Drain Layer's L License No.' , 44'�7 Permit will expire on { ",Fwfi,Mtn 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
Signed .
Connection Charge Paid Licensed in Layer
a. 915 Issued by In 1s,r7..r�i1^+� , �tr'. -
Tax Collector
Permit Fee:. Paid TIM
_
INSPECTION: Check Number: 2a''1
INITIAL (Sig)
FINAL (Sig)
APPROVED/ 4 (Date)
TOR (Sig)
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