HomeMy WebLinkAboutDrain Layers Permit 142 Benedict Drive (2) TOWN OF -SOUTH WINDSOR
-- DEPARTMENT"oOF• POLLUTION CONTROL
South Windsor, Connecticut_ 2217
DRAIN LAYER'S PERMIT N? 399
scut. 4 19114
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 142' 13411kOdItt Dre on the
side, between Im ow & Dim* Dr.
at premises owned by air 2t1y*1u &,'
whose address is
and to I Lay House Drain, Repair House Drain, Lay Main, Other
for idd
occupancy or use,
with *no 0) Family Units, with acres.
Type of Sewage to be connected under this permit:
CANITARY SEWAGI), INDUSTRIAL WASTES, OR
Connection will be made with 1613C 1310h #6) PULilt TAP*
Permit to be issued to 40ba A. Zesaft
the holder of Drain Layer's License NoY944%18 Permit will expire on Iwo 4 19"
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 M *T toPMP# 01"6 bf-Wf l 1ORPU ' UWk
�y Signed
Connection Charge Paid 1f r" Licensed Drain Layer
Porgy to I O"$ i A. $tam1&*r Jr*
Tax Collector (Sig) Issued by
Permit Fee: Paid $ 1!;#
INSPECTION: SME
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
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