HomeMy WebLinkAboutDrain Layers Permit 25 Benedict Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: Se-Q✓3 Z
DRAIN LAYER'S PERMIT N? 922
, 19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 2L; L,,iedict yi'v C3 (L 14) on the
side, between
at premises owned by
whose address is 6nnae
and to Ei Lay House Drain, Repair House Drain, Lay-Main, Other
for Res-i d,r;nti i. occupancy or use,
with Unv Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with �3i
Permit to be issued to I c
the holder of Drain Layer's License No. ti'.`--` 2'06,?T? 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
r
Signed
Connection Charge Paid i.;l- Licensed Drain Layer
3A r Issued by T.
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR