HomeMy WebLinkAboutDrain Layers Permit 315 Benedict Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut G:i�1�11
List.No.: _
DRAIN LAYER"S PERMIT NO 1503
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at *3ZS �eyw/�ICE' Or, on the
side, between
at premises owned by Lt9 r2 N A. M A 10-1 1&1
whose address is
and to _ Lay House Drain, Repair House Drain, Lay-Main, Other
for dQC54.PEhV occupancy or use,
with �/V'E Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (V,), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with
Permit to be issued to �- ®N
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 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 p04
Connection Charge Paid ).'Zt[Q Licensed Dfain Laryer
q'f—7 g Issued by
Tax Collector
Permit Fee:. Paid $ _
INSPECTION: Check Number: — �
INITIAL (Sig)
FINAL (Sig)
APPROVED q-/f- —7f (Date)
'k . T,��144 INS TOR (Sig)
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 3/S Nt.Plc7- nelple-
OWNER 404AJ
TYPE OF WORK C0NN€G7)AA1
DATE 9-/Z- PERMIT 16d a PIPE G PVC
INSTALLER 4�m s oAJ
INSPECTOR DRAWN BY �'