HomeMy WebLinkAboutDrain Layers Permit 300 Benedict Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut�S-
List.No.: _
DRAIN LAYER'S PERMIT NO 15,71
, 19 Tj_
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 3®® L 144Em(G T on the
side, between {�
at premises owned by R D tA A J=F N C j
whose address is 5A M 6
and to Lay House Drain, Repair House Drain, Lay Main, Other 41 p /
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit: / rjp`�r^ l A= ✓�,��/�//��
SANITARY SEWAGE ( ), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to 0 mz —,
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 -#-13 O 3 Licensed Drain Layer
I-- 3nd 2` Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL X-7 d 9 (Sig)
APPROVED (Date)
INSPECTOR (Sig)
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NOTES SOUTH WINDSOR POLLUTION CONTROL
: LOCATION c i
)3 a.� OWNER
TYPE OF WORK
DATE 3 -Z2 PERMIT PIPE,
INSTALLER
INSPECTOR
EASTERN SEWER PIPE CORP.
3320 BERLIN TURNPIKE•NEWINGTON,CONN.06111 PHONE(203)666.5634
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