HomeMy WebLinkAboutDrain Layers Permit 0256 Avery Street (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut j 3 ¢
List.No.: _
DRAIN LAYER'-S PERMIT N? 1178
c,vS L<36Z 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at LCn fa v fit- on the
�`-Ya6T side, between �� c�� ✓i \ �� q ��c_��,1j
at premises owned by
whose address is
and to -� Lay House Drain, Repair House Drain, Lay-Main, Other
for �4K71Tk A occupancy or use,
with 0�c Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (�� INDUSTRIAL WASTES ( )), OR
Connection will be made with 941 i't %,N Cu 1'Z11141�1= t t
Permit to be issued to. V,�� n y'u�eLS�L�
the holder of Drain Layer's License No. W'�1—Z0'9c1- Permit will expire"on
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 G
Connection Charge Paid Licensed DrainLayer
Issued by Iv` • � �w.-o�t.�.�l t'�1 c,�tl�
Tax Collector
Permit Fee:. Paid $ 6
INSPECTION: Check Number: ,
INITIAL A (Sig)
FINAL A (Sig)
APPROVED71V AL� (Date)
Wo 1 ?
-4 T (Sig)
IN PECTOR
N
�u
v
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION Lia 79
OWNER R'...oeg
TYPE OF WORK Lkooc
DATE PERMIT PIPE 'Pkf&
INSTALLER
INSPECTOR RAWN BY
TOWN OF SOUTH WINDSOR
TOWN HALL
SOUTH WINDSOR, CONN. 06074
DEPARTMENT POLLUTION CONTROL
Date . .(. . . . .
The Sanitary Sewer . . . . . Septic System. . . . . . . . . . .
per J+,�e4
at . . . . . . . . . . . . .
or lot #. . . ... . . . . . . . . . ., has been installed and completed
in accordance with the Town of South Windsor ordinances
and regulations.
Accepted and Approved
$y � ' — _ Date ®/ P(•'��rt