HomeMy WebLinkAboutDrain Layers Permit 0595 Avery Street (2) TOWN OF SOUTH WINDSOR .�
DEPARTMENT OF POLLUTION CONTROL
p. South Windsor, Connecticut
List No.: f
DRAIN LAYER'S PERMIT NOS 744
am , 19 74
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ;-M' jr& "Z"k on the
side, between
at premises owned by ' '
whose address is
and to Lay House Drain, Repair House Drain, -- Lay`Main, Other
for V4144fttiai occupancy or use,
with '$ Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, INDUSTRIAL WASTES ( ), OR ( j
Connection will be made with 1 40—* 0 lat
era kNOW. 04 It • ry a � �,
Permit to be issued to +
the holder of Drain Layer's License No. Permit will expire on 25 19 ,75 .
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
Connectiof:Charge Paid 'f` —'f Licensed Drain Layer
6
Issued by
Tax Collector
Permit Fee: Paid $ _
INSPECTION: Check Number: `
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR