HomeMy WebLinkAboutDrain Layers Permit 0769 Avery Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
t
DRAIN LAYER'S PERMITO 49 '
7 69
. - 9WINIAM 19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Ift antir Inert, on the
side, between DO@' SA Abd
at premises owned by 'tt '
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for a occupancy or use,
with milk Family Units, with acres.
Type of Sewage to be connected under this permit:
(SANITARY SEWAGE%- INDUSTRIAL WASTES, OR
Connection will be made with 4 V14 #
Permit to be issued to A. vita
the holder of Drain Layer's License No. Permit will expire of & ,847 19
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
Connection Charge Paid W Licensed Drain Layer
g MA (Sig) Issued by l r.**ltl s '40
Tax Collector
P rmit Fge: Paid $
INSPECTION: -
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR