HomeMy WebLinkAboutDrain Layers Permit 187 Benedict Drive � f - TOWN OF SOOTH WINDSOR
DEPARTMENT OF. POLLUTION CONTROL
South Windsor,.Connecticut
DRAIN LAYER' S PERMIT0 247
719 73
' w Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at i p C L 2,Z)
on the
z..
.+ side, between C +N pA/1_ p 't- l 1 i-''e fit yc-
at premises owned We ems'
whose
ose address is e' off.£ fi P
and to Lay House Drain, Repair House Drain, Lay Main, Other
for es !, ./T�� � occupancy or use,
with Family Units, with { acres.
Type of Sewage to be connected under this permit: e
SANITARY SEWAGE) ,INDUSTRIAL WASTES, OR
Connection will be/made with
Permit to be issued to 0 0Aj
the holder of Drain Layer's License No. Permit will expire-on _ '49 i4-f _5— 19 7.3
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the perm and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS `# S `
F
Signed
Connection Charge Paid ' _,;, Licensed Drain Laye
(Sig) issued by
Tax Collector
Permit Fee: Paid $ q
INSPECTION: }
INITIAL , (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
N
K4
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE PERMIT PIPE 77,1s 7'
INSTALLER
INSPECTOR ,v J DRAWN BY