HomeMy WebLinkAboutDrain Layers Permit 0630 Avery Street (4) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: .5 o 0
DRAIN LAYER'S PERMIT
p 691
, 19
Pursuant to>written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
tftt side, between N Md it T
at premises owned by vaftw
whose address is SIM
and to X Lay House Drain, Repair House Drain, Lay Main, 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 0"0 PIP t* * W tw4ta, 11+37. * ot a dopft
77
Permit to be issued to Adoft
the holder of Drain Layer's License No. Permit will expire on 19 74
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
..r. Signed
Connection Charge Paid Licensed Drain Layer
Imo. 6-18 -A w�.
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED t• Or.t° j- s t (Date)
ICY" Aw
(Sig)
t , iTTSPE