HomeMy WebLinkAboutDrain Layers Permit 145 Benedict Drive (2) TOWN OF SOUTH W!N DSOR
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{ DEPARTMENT OF POLLUTION CONTROL
B/P No.
� � rs South Windsor,_Connecticut
List No.. § '
DRAIN LAYER'S PERMIT
NID 538
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side; between Tins
at`premises owned bye
whose address is naisrn
and to I Lay House Drain, Repair House Drain, -Lay Main, Other
for occupancy or use,
with. Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE O, INDUSTRIAL WASTES _( ), OR ( ) —
Connection will be made with Mdy (f$
Permit to be issued to
the holder of Drain Layer's License No. s Permit will expire on jWW 93 197
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
Signed
Connection Charge Paid 4/", Licensed Drain Layer.
Issued by 144A A* 3' W r Jr* .
Tax Collector
Permit Fee:. Paid $ _'__00
_._
INSPECTION: Check Number:
i,
INITIAL : t f (Sig).
FINALr _ =sr` (Sig)
APPROVED' - Y "`�h , Date)
(Sig)
INSPECTOR "
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