HomeMy WebLinkAboutDrain Layers Permit 89 Benedict Drive °q
TOWN . .OF SOJTH
v1� IDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, nnecticut 3.1-67-33
List:No.:
DRAIN LAYER'S `PERMIT 931
141
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at li► et pi t i, f; L 20 r R` 'on the
side, between
at premises owned by
whose address is
and to ___3LLay House Drain, Repair House Drsin, Lay-Main, Other
for Rir�ri�ia occupancy or use,
with Sri' Family Units;.with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ►j, INDUSTRIAL WASTES .{ ), OR { )
Connection will be made with .2ir ls'
-r
Perms tq,' issued to 101111f,"ilik;,
` the holder.6I4Q.4!A Layer's License No. "" 'y�} Permit will expire on 19
The undersigned Drain Layer hereby agrees to all 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 blift Arr-UjAk
,,,,pax Collector
PAr
u Fee:. Paid $ —
SP G7�ION: Number:
INITIAL (Sig)
FINAL (Sig) F;
APPROVED (Date)"
(Sig)
INSPEGTQ
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