HomeMy WebLinkAboutDrain Layers Permit 425 Benedict Drive (2) V,
t- 3 TOWN OF SOUTH WI N DSOR T
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor,,Connecticut
List No.: "' 1
DRAIN LAYER'S PERMIT
O 714
X * tab- 19
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
at premises owned by ', .►
whose address is am
and to X Lay House Drain, Repair House Drain, Lay-Main, Other
for ,�ffiifiifi occupancy or use,
with mo 0) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with `` k4� Aa� Stu 554 i
Permit to be issued to Aft U 1 ,
the holder of Drain Layer's License No._ Permit will expire on 34 19 f
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 ` Licensed Drain Layer
Issued by � ' '�
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL -� �a µ (Sig)
FINAL /6/3l 0 ll�vd ---^" `" (Sig)
APPROVED J C'e 44e r 1974— (Date)
(Sig)
INSPECTOR