HomeMy WebLinkAboutDrain Layers Permit 47 Benedict Drive (2) 15, , F= -
TOWN OF SOUTH WI N DSOR
1 41 DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
- - DRAIN LAYER'S PERMIT NO 306
r , 19
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 : r'a
whose address is
and to 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 INDUSTRIAL WASTES, OR
Connection will be made with
=`
Permit to be issued to � - �`, c 1
the holder of Drain Layer's License No. Permit will expire on �- 19 ,
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit an 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 $ ;.. Licensed Drain Layer s '
(Sig) Issued by #' ,
Tax Collector
Permit Fee: Paid $
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED '-- = (Date)
INSPECTOR (Sig)