HomeMy WebLinkAboutDrain Layers Permit 0812 Avery Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut S�, 1132
List No.: _
DRAIN LAYER'.S PERMIT NO ii 5
O� t�lo��r►,a , 1�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
C s-r side, between
at premises owned by V.19"M6-V l
whose address is %'AWl.c4
and to Lay House Drain, Repair House Drain, Lay Main, Other
for ►J`AWL-- occupancy or use,
with 81L6 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 im A
the holder of Drain Layer's License No. Permit will expire on4Oq Sp�`A 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
Connection Charge Paid ((.16W-1 G +A Licensed Drain Layer
10 4-( Issued by 1�\. �+►tif5�t_V �Tz tw
.Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
N
94'
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION rd 1 Z. A vev7t ree-
OWNER YYI,-
the
TYPE OF WORK Hoy Coh %o
DATE ;.W6mxtsx76 PERMIT PIPE Mc.
INSTALLER c.t VCvv s
INSPECTOR ,M.�-4t�,, DRAWN BY (