HomeMy WebLinkAboutDrain Layers Permit 0276 Avery Street (2) r TOWN OF XUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL {
South Windsor, Connecticut
DRAIN LAYER'S PERMIT N? 311
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
3
_side, betweenSW
_
at premises owned by %Mau
whose address is JOW
and to -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 SEWAGI INDUSTRIAL WASTES, OR
Connection will be made with ..
Permit to be issued to
s�
the holder of Drain Layer's License No. Permit will expire on 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the P87�a the reverse siv—
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS__
Signed
Connection Charge Paid $ Licensed Dran`Layer
(Sig) Issued by NM"7 A
Tax Collector
Permit Fee: Paid $
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR