HomeMy WebLinkAboutDrain Layers Permit 44 Benedict Drive (2) ` TOWN- OF
SOUTH WINDSOR -
DEPARTMENT.OF POLLUTION CONTROL
B/P No:-
South Windsor, Connecticut "
List.NO.. _
DR"AI'N LAYER'S PERMIT , 6
4
2.
y'
, 4
r �y AI ANANWhim ' 19
.- Rursug nt to written applicatior, permi-ssion is hereby granted to the Licensed Drain Layer;named herein.to perform
theawork indicated below at on the.
side, between
at premises,owned by AJAW' +�J� 1.'
i whose address ism
and to '_,21. Lay House Drain, Repair House Drain, Lay,.-Main,, rt. Other R $
for
;. --� •e�•..•.� J occupancy or use,
with i t '': ` Family Uni4s, with
pe ofeaje td"1`ie i olected`undei'phis permit: .
SANITARY SEWAGE ( , INlYVST1*AL WAS S _( ), OR ( ~+,
.. '
y ,iConciection ovill be inade,witlgo-4iia (4)l
- Per
to tie isaecl,tQ
S the-holder of Drain Layer's License No� Permit will egplre on � R' 19 ,
:The undets;fined Drain Layer he;ebb agrees to all the terms and conditions set forth pfl.the permit and:the el"side
�.
there'o£ Appiicant.has received Town Permit No. and/or C H U Permit No.-
for street'<e'gcavaton
SPECIAL CONDIXJONS
L
� t
Signed. �'41-
Connection-Charge Paid Licensed Drain Layer.
-- # Issued-by
Tag Collector >. a
Permit Fee:. Paid
INSPECTION: •Check Wum6er T
INITIAL �y': (Sig)
ONAL (Sig)
c t
APPROVED- 1.4,,6., : (Date)
'A"
'A (Sig)
Z INSPECTOR -
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