HomeMy WebLinkAboutDrain Layers Permit 187 Benedict Drive (2) TOWN Of S . H. WtN'DSOR
` s '.DEPARTMENT OF :!POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT0 24
.. • , 19
.. - -. Y -
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 by dy•,wa,-
whose address is = j; <1.
and to } Lay House Drain, Repair House Drain, Lay Main, Other SfF 4: •r_. s ifAe
1
for c s - occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit: _ 4 Ic
SANITARY SEWAGE INDUSTRIAL WASTES;_ OR .
Connection will be ��made with
Permit to be issued to f a
the holder of Drain Layer's License No. Permit will expire on19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permif and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
' for street excavation.
` SPECIAL-CONDIT'IONS
Signed t
Connection Charge Paid if %",. ,F ,t Licensed rain Lay .
1 t (Sig) Issued by '' `<, r� c
Tax Collector
Permit Fee: Paid
INSPECTION: f j .
INITIAL j (Sig)
FINAL `.0 (Sig)
APPROVED _ (Date)
-i .. (Sig)
INSPECTOR