HomeMy WebLinkAboutDrain Layers Permit 69 Benedict Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT NO 406
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 69 Ben*aet L x on the
*&it side, between AP*rY St pJA0 TV"
at premises owned by
whose address is sox*
and to Z Lay House Drain, Repair House Drain, Lay Main, Other
for residential occupancy or use,
with OSe M Family Units, with acres.
Type of Sewage to be connected under this permit:
(SANITARY SEWAGE) INDUSTRIAL WASTES, OR
Connection will be made with 4dX inch (6) plastie pipe
Permit to be issued to _ Willim MaKiaw
the holder of Drain Layer's License No. W9-20W8 Permit will expire on NOV# 10 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 Drat 3 IWea tO VMP tCrU$h and baQktiU tia tUk
Signed
'
Connection Charge Paid $08- 1--73 ° Licensed Dt L er
Ptr. Z. I I A. 8thsr
(Sig) Issued by
Tax Collector
Permit Fee: Paid $.1!j.0Q
INSPECTION: ch"k �•*•-•-
INITIAL (Sig)
FINAL (Sig)
APPROVED ' � — /�f - (Date)
f t
�. (Sig)
INSPECTOR