HomeMy WebLinkAboutDrain Layers Permit 0400 Avery Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut List.No.: _
DRAIN LAYER'S PERMIT NO 1874
'as , 19 "7�
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to"perform
the work indicated below at - on the
side, bet been
at premises owned by-
whose =Lay
V
and toouse Drain, Repair House Drain, Lay-Main, Other
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to Yoh (_i r+,�Ne rEf e (�
the holder of Drain Layer's Pcense No. Permit will expire on 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
�Z SignedLAII -.11
Connectior� } rge Paid 2r�� Licen ed Drain La er
Issued by
,;,Tax,.(Follector
7?7 Permit Fee: Paid $
INSPECTION: Check Number: Z /
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)