HomeMy WebLinkAboutDrain Layers Permit 0199 Avery Street (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT O
tT. 498
' , 19 73
Pursuant to_written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned by
whose address is JIM
and to Lay House Drain, Repair House Drain, Lay Main, Other
-for
occupancy or use,
with aft, 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
the holder of Drain Layer's License No._ Permit will expire on 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 view.
Signed
Connection Charge Paid "Licensed Drain Layer '
hr so mat" 41*0
Tax Collector (Sig) Issued byi
Permit Fee: Paid $ '
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR