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HomeMy WebLinkAboutDrain Layers Permit 97 Benedict Drive ~ TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut List No.: DRAIN LAYER'S PERMIT NO i356 Pursuant to written applicati�o/r, perm' Sion is�he�eby granted to the Licensed Drain Layer named herein to perform 9 / e Q IC„�1 /� on the the work indicated below at �'� side, between at premises owned by— whose address is and to Lay House Drain, Repair House Drain, Lay-Main, Other for occupancy or use, with Family Units, with acres. Type of Sewage to be connected under this permit: SANITARY SEWAGE (V), INDUSTRIAL AS , OR Connection will be made with— Permit Permit to be issued to the holder of Drain Layer's License No. 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 ` Signed Connection Charge Paid Licensed Drain Layer - II- )P- 77 Issued by Tax Collector Permit Fee: Paid $ _ ' INSPECTION: Check Number: INITIAL (Sig) FINAL (Sig) APPROVED f2 Z (Date) me (Sig) INSPECTOR 7 s ° NL A�19 C�� i i - i Igel.,e 0 I � I 5 aC,U►H WN);O.0 POU-UTION CON Rol LOCATION ly IpEptAirl ),?CZ� ]PIPE o rw spECTOR r)RANN©Y •• Y'•l :s54._nLS�. ?•ice:.'__'::Y�.�`...w:.