HomeMy WebLinkAboutDrain Layers Permit 0480 Avery Street TOWN OF SOUTH WINDSOR
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DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _ -
DRAIN LAYER'S PERMIT N? 655
Sojkt- 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at F4 yoy-v SiMet on the
side, between
at premises owned by- Daxiel La'enta
whose address is SMO
and to _XLay House Drain, Repair House Drain, Lay-Main, Other
for Raptidestml occupancy or use,
with ORO Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( X), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with Six iftok tllmtie0
Permit to be issued to Robert L. Davis
the holder of Drain Layer's License No. W-9205935 Permit will expire on 10f 20�'4 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
4>-
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Signed '
Connection Charge Paid 573 Licensed Drain Layer
G911� Issued by Frask J• Smith►
Tax Collector
Permit Fee: Paid $ _—A5±00
INSPECTION: Check Number: ,1 +
INITIAL (Sig)
FINAL (Sig)
APPROVED- (Date)
(Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION gagel., SA
OWNER
TYPE OF WORK
DATE PERMIT -5 PIPE
INSTALLS
INSPECTOR DRAWN BY
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