HomeMy WebLinkAboutDrain Layers Permit 16 Benedict Drive TOW.N OF SOUTH W�N DSOR
DEPARUENT OF P.OLLUTIbN CONTROL B/P No.:
South Windsor, Connecticut ��1:,-.3�'
List No.: _
DRAIN LAYER'S PERMIT Np 898
71't8l75 , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ,6 ".Qt DKYS on the
side, between
at premises owned by rlw* No stmb
whose address is
and to X 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 SEWAGE ( ), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with Six XWh MSBUO npe
Permit to be issued to AdW WiMiewaki
the holder of Drain Layer's License No. W"'9 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
Connection Charge Paid Licensed Drain Layer
Issued by li"k +
Tax Collector
Permit Fee:. Paid $ _15*00Y i
INSPECTION: Check Number:
INITIAL / ;3 (Sig)
FINAL .1:) (Sig)
APPROVED . '" (Date)
(Sig)
INSPECTOR