HomeMy WebLinkAboutDrain Layers Permit 79 Benedict Drive (3) TOWN OF SOUi WINDSOR
DEPARTMENT 6P POLLUTION CONTROL
South Windsor, Connecticut
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DRAIN LAYER'S PERMIT _ 0 395
Auk 19�_
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 'lA BaNW4a are on the
Mg* side, between A V!M Is y"� 1
r
at premises owned
whose address is
and to X_Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with QW {f) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with Ady Insh ( ) U4&4& pjp&
Permit to be issued to,
the holder of Drain Layer's License NCI Permit will expire on Oat. 13.�
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 DkM 3AM 110 VMS ! i md buid n #e>a Us tt
Signed
Connection Charge Paid ., Licensed Drain Layer
poro (Sig) Issued
Tax Collector
Permit Fee: Paid $
INSPECTION: f ..�....,.
INITIAL , (Sig)
FINAL. (Sig)
APPROVED Cy Y—. / —7.3 (Date)
INSPECTOR �'"'