HomeMy WebLinkAboutDrain Layers Permit 200 Benedict Drive l '
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 2610
19 � L
Pursuant to written applicatior, permissi is hereby granted t e Licensed Drain Layer named herein to perform
the work indicated below at �_ l on the
4
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 ( ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with
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 &W.
Con Charge Paid 7 Licensed Drain Layer
el
acea
Issued by
Tax Collect r ��j,
Permit Fee: Paid $ 1�-� 2
INSPECTION: Check Number:
INITIAL (Sig)
FINAL --/® (Sig)
APPROVED --;&� 44
(Date)
(Sig)
INSPECTOR