HomeMy WebLinkAboutDrain Layers Permit 0620 Avery Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.: 1-1,
South Windsor, Connecticut �6094�
List.No.: _
DRAIN LAYER'S PERMIT
746 +o.a N° 1033
T08 March , 19 76
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to'perform
the work indicated below at 620 Avery Street on the
east side, between Kelly Road and 4md and Drive
at premises owned
whose address is same
and to :{ Lay House Drain, Repair House Drain, Lay Main, Other
for residenti<+.J_ occupancy or use,
with or,. (1) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with si i n(:11 (01) t)l n gti -ii nP to a "l ntaral -known As-sta. a t
rn
;lenth of 6.01+
Permit to be issued to F-R'. Kuczi
the holder of Drain Layer's License No. W9-207134 Permit will expire on_ 08 May 19 76
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 Drairi_Layer to burin crush and backfill septic tank.
Signed f �•- _�_._
Connection Charge Paid 0 -0- .76 Licensed Drain Layer
Rec a /`1 <a31
- Issued by rielvin Edwards, J:r.
Tax Collector
Permit Fee:. Paid $ _1 5.00
INSPECTION: Check Number: ,
INITIAL z-- (Sig)
FINAL m3/o f C✓ /s4e3 (Sig)
APPROVED 4 A.4W /974a (Date)
+ . ZL � (Sig)
INSPECTOR
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STA, 9+s9
At/E2�/ �s2taF?'
NOTES SOUTH WINDSOR POLLUTION CONTROL
Not drawn to scale. LOCATION 620 Avery Street
OWNER BAKER Louis G. & Laraine Z.
TYPE OF WORK House Connecti2n
DATE -03/o fi 7� PERMIT 1033 PIPES"q,B, S.
INSTALLER Kucza (W -2071 4)
INSPECTOR /'�-� DRAWN BY
r� 47/7C