HomeMy WebLinkAboutDrain Layers Permit 0656 Avery Street (2) TOWN OF SO1U# ' .. W1NDS4R
DEPART4E.NT OF POLLUTION CONTROL
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South Windsot, Connecticut
DRAIN LAYER'S PERMIT "O 234
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• , 19
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Pursuant to written application, permission is hereby grapted to the Licensed Drain Layer named herein to perform
¢ the work indicated below at ft atraek on the
ASIM side, between
at premises owned by o irm
whose address is
and to ay House Drain, Repair House Drain, Lay Main, Other
} for occupancy or use,
with 10 Family-Units, with acres'.'
Type of Sewage to be connected.under this permit:
0NITARY 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 n 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit andthe reverse side
thereof. Applicant-has received Town Permit No. and/or C H D Permit Nb.
for street excavion. -
SPECIAL CONDITIONS t
Signed t= �' "
g Licensed fain Lay
Connection Charge Paid _
(Sig) Issued by +► '
Tax Collector
Permit Fee: Paid $
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED OX %&48 t '" (Date)
(Sig)
SP. CTOR