HomeMy WebLinkAboutDrain Layers Permit 0595 Avery Street `- TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.: �
South Windsor, Connecticut
List No.: S .-
i +t
76 �++ DRAIN LAYER' S PERMIT No 744
19
.Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
wetRt side, between G --f "bad tnti Beeljo ttb P-cati
at premises owned by 're dtrn rk 1. i{rtmxer «'o
whose address is Mrie
and to A Lay House Drain, Repair House Drain, Lay-Main, Other ,
for r E#sidentiol occupancy or use,
with one (i) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, INDUSTRIAL WASTES .( ), OR ( ) a
Connection will be made with� -��� r" (s� s 3�a tr r= l y known Sya p g
dosth of
Permit to be issued to J,41rmr3 O. Ac,`,sr
the holder of Drain Layer's License No. Iz -P %5777 Permit will expire on P5 Jmr?z Xra 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
Connec 'o Charge Paid `I .11�44 Licensed Drain Layer
*fyt No. Issued by e:trr:�t°3.21 rdwm,3°1r, a"r.
Tax-`Collector
Permit Fee: Paid $
INSPECTION: Check Number:K tsr' 705
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
c
(Sig)
.JINSPAC—TOIk---
N
1
NOTES SOUTH WINDSOR POLLUTION C NTROL
LOCATION
OWNER
TYPE OF WORK
DATE ':/" - .., PERMIT ` PIPE
INSTALLER
INSPECTOR DRAWN BY