HomeMy WebLinkAboutDrain Layers Permit 145 Benedict Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut "
List No.: „
DRAIN LAYER'S PERMIT
p 538
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at lie 24MUst ft. L 2 O on the
side, between NMV PIM 2M Wit,
at premises owned by
whose address is
and to , '�' Lay House Drain, Repair House Drain, - Lay-Main, Other
for_nlrE occupancy or use,
with attar Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE O, INDUSTRIAL WASTES .( ), OR
Connection will be made with + f �
Permit to be issued to f :
the holder of Drain Layer's License No. Permit will expire on_ J * 93 197
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- I
Signed "f= , , .._. ..
Connection Charge Paid _ Licensed Drain Layer
Issued by ". As ftalklmsatkW 0o
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL a' p exn" (Sig)
FINAL1` ir° ?_ (Sig)
k
APPROVED' '..� " (Date)
(Sig)
"r INSPECTOR _
N
c�
1
i
� r
1
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION JqJ- faci C',
OWNER F ERr cor.To V
TYPE OF WORK w*,/rA 1-076RAL
DATE PERMIT PIPE
INSTALLER ,�-i s v r✓
INSPECTOR DRAWN BY R