HomeMy WebLinkAboutDrain Layers Permit 0648 Avery Street TOWN OF S O -, W1 N DSOR
DEPARTMENT OF TION CONTROL
►+ South.Windsor, Connecticut
+ Tt" DRAIN LAYER'S PERMIT NO 233
k Y1,14*W 0000 30 no 119 23
Pursuant.to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
xhe work indicated below at M AV
stmt on the
-080 side, between Mur amd Affid whMa ngiye
at premises owned'by RC&*,Vt F., ft 44 Sri
dose address is
A48co X La#House Drain, Repair House Drain, Lay Main, Other
` fairer occupancy or use,
with 0 W Family Units, with acres.
Type of Sewage to be connected under this permit:
s (SA rFARY SEWAGE) INDUSTRIAL WASTES; OR
Conned; on will be made with D"Afte Pilo
f
Permit toA is ued to Bit. 1bP*i f0 ftUb**Ok C4"Oft
the holder of.Drain Layer's License No. V9-W6110 Permit will expire on 30 'J :
19
The undersigned Drain Layer:hereby agrees to all the terms and conditions set forth on the permitt�and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
3 SPEC AL CONDITIONS s V 1i7 e '
.
Signed
onnectio Charge Paid -14 Licensed 15rain La�e
1-1i
(Sig) Issued by X Jr.
k Tax oll - toi
Permit Fee: Paid $.15i
INSPECTION:
ITIAL - (Sig)
(Sig)
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1. d T rA Ja (Sig)
I SPECTOR.
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER Pggi= I. �T
TYPE OF WORK
DATE - 3 PERMIT 233 PIPE e. ° uos
INSTALLER a u4 - ov
INSPECTOR r-,,c s DRAWN BY