HomeMy WebLinkAboutDrain Layers Permit 0741 Avery Street (2) TOWN OF SOUTH WI D N SOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut BAP No.: 4-1r
List No.. _
DRAIN LAYER'S PERMIT
N? 51'7
D"o , 19 73
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below.at Jlrra g
on the
side, between
Y a
at premises owned byti2` gsr
whose address is i
# and to - La H Drain,
n Repair House Drain, Lay-Main, Other
for rf . E' 41 '
occupancy or use,with Family Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE X `
I ( �, INDUSTRIAL WASTES .( ), OR
Connection will be made with IdX UC+W) C*At iz
Permit to be issued to C►h&r4 pipet
the holder of Drain Layer's License No. 06363Permit will expire one 19 _
k The undersigned Drain Layer hereby agrees to al73
l 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 �* SWOP
�F a CrWlh #► efptio t �
O;sr is t *fd to 'at* citY Wgttsr if lad w> ► x a
"Moled air
:Signed..
Lion Charge Paid 1/"� Licensed Drain Layer
re No Home
>ollector
Issued by ftlA 8t4U*Vft Ar Jr.
Permit Fee:. Paid $ _ 5000
INSPECTION: Check Number:
INITIAL (Sig)
FINAL
(Sig)
APPROVED (Date)
INSPECTOR (Sig)