HomeMy WebLinkAboutDrain Layers Permit 59 Benedict Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL gip No.: _
South Windsor, Connecticut
List.No.: � fs
DRAIN LAYER'S PERMIT
p 650
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 91� TIAamh Ott Drtro L t`7
on the
side, between
at premises owned by rkN to ; s 0
whose address is ftme
and to Lay House Drain, Repair House Drain, Lay Main, Other
for V�trd,&*'Tax 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 Imsh Pip
Permit to be issued to M&A W1, UV 1
the holder of Drain Layer's License No. V-;MA. Permit will expire on t 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 q,,"j%/*74 Licensed Drain Layer
Issued by
Tax Collector
nrl
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL 1', (Sig)
APPROVED _' (Date)
(Sig)
INSPECTOR