HomeMy WebLinkAboutDrain Layers Permit 321 Benedict Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Wintsor, C`'onnecticut
f, DRAIN LAYER'S PERMIT N? 352
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Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at # !t gn,(Ut 1 ) on the
—� side, between
at premises owned by Lo
-
whose address is
and to 'X Lay House Drain, Repair House Drain, Lay Main, Other
for
occupancy or use,
with W Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with 4X*4X4& (6)
Permit to be issued to AAM Wil"SWIft
the holder of Drain Layer's License No. W�_ "9 . Permit will expire on ��
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 VJIM ISM tO VWV9 *rU* "41 t*lk= MWO t8lik
1
Signed`S {
Connection Charge Paid $ Licensed Drain Layer
P03P s Ne"s (Sig) Issued by IMPk A* X kah-MU' ire
Tax Collector
Permit Fee: Paid $
INSPECTION: NUMbo1"
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
A
'C.z
115
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 32/ gzw'Cofv=r"
OWNER ,,
TYPE OF WORK
DATE PERMIT Z.2 PIPE G
INSTALLER i r
INSPECTOR 5' DRAWN BY '�