HomeMy WebLinkAboutDrain Layers Permit 69 Benedict Drive (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT 16F*PBLLUTION CONTROL
South Windsor, Connecticut
-1 .3
DRAIN LAYER'S PERMIT NO 406
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned bye am
whose address is ilk
and to Lay House Drain, Repair House Drain, Lay Main, Other
for w4fift"
1 occupancy or use,
with 0) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGI), —INDUSTRIAL WASTES, OR
Connection will be made with
Permit to be issued to V
the holder of Drain Layer's License No Permit will expire onftv# 16 1922
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse siaj
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS OOM& Wd N
Signed
Connection Charge Paid "� 1� Licensed.I3'a' L4y rloft so- No"s
A
Sig Issued b »"
Tax Collector
r
Permit Fee: Paid $� "
INSPECTION: � rrrrrt
INITIAL (Sig)
FINAL _ �' (Sig)
APPROVED— � — /<f / (Date)
�. T"': C• ---�.:..�' (Sig)
INSPECTOR