HomeMy WebLinkAboutDrain Layers Permit 44 Benedict Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.: 1
South Windsor, Connecticut
List No.: S 3
DRAIN LAYER'S PERMIT N? 642
-- et4mbwr} , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 44 Viwr"irat meta, on the
p111 side, between =tee►
at premises owned y Arvor jo fit Us
whose address is
and to . _Lay House Drain, Repair House Drain, Lay-Main, Other
for good�w_ occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
F.
SANITARY SEWAGE ( , INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with �_ ok pUetig pipe
Permit to be issued to Adm Wen1asriki
the holder of Drain Layer's License No Permit will expire on 04 19 74
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
f •
Signed =
Connection Charge Paid Licensed Drain Layer
t Issued by N,
ax Collector
Permit Fee: Paid $ _ 40-
INSPECTION: Check Number., -
INITIAL t;; ' (Sig)
FINAL (Sig)
APPROVED rt : ,:r r (Date)
:may (Sig)
INSPECTOR
N
v
4 Q
t,K
♦4] 0
7
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 4
OWNER
TYPE OF WORK S
DATE PERMIT Ll 3, PIPE :a
INSTALLER s
INSPECTOR DRAWN BY