HomeMy WebLinkAboutDrain Layers Permit 0500 Avery Street (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT
p 2481
19
, J
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at %`CV 4tv,to
v
on the
side, between
i
at premises owned by 10
whose address is ,i
and to Lay House Drain, Repair House Drain, La -Main,Man Other
for '
occupancy or use,
with Family Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, 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 1
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 1`4PJ /2'— j Licensed Drain Layer
�` =�v�r� Issued by
Tax Collector
i`
Permit Fee:. Paid $
_ INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)