HomeMy WebLinkAboutDrain Layers Permit 0648 Avery Street (2) TOWN- OF S
} Wt N DSOR
% A DEPARTM�'NT OF P LUTION CONTROL
+ + �Sauth Windsor, Cdnrfecticut _
' ►' , " DRAIN :=LAYER'S PERMIT NO 23
19
Pursuant:to written appii-anion, permission is her granted to the LicensedSDrain Layer named herein to perform
a, �,
the work indicated i5elow at 4"IM A on the
4
M
3: side, between '
at premises owned b ambeftJ4 am" t
se,Address is ANN, --+!
to LaHouse Drain', Repair House Drain, Lay Main, Other
fa; occupancy`�r use,
with 0 Family Units, with acre. ,
Type of Sewage to be connected under this permit:
SANITARI'SEWAGE r
•-IDTDUSTRIAL WASIES, OR 7
Conneetion will be made with >i (90 AARMM ANA '
Permit to ' ised,to 4.1
the holder of Drain Layer's License No. Permit will expire on _�i9
The undersigned Drain Layer-,hereby agrees to all the terms and conditions set forth on the permit and.the revee i_.rsde
thereof. Applicant has received Town Permit No and/or C H D Permit No.
for street excavation.
SPEC L CONDITIONS ,
1
Signed
Gonnecti n Charge Paid Licens:.d grain Laid
(Sig) Issued by firo
Tax Col ector
Permit Fee: Paid $
INSPECTION:
�INITIA ._ ,. (Sig)
MINA: (Sig)
APROVED # "'�; (Date)
J&
.w,. (Sig)
1NSPECTOR