HomeMy WebLinkAboutDrain Layers Permit 15 Ahern Drive ' TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
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Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform the work indicated below at ;�-/S A4CIeAl
at premises owned bye/jyry� ,�L,T� ,S��J whose address is
/L� �/ir �'/✓ G' /c' iU 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 01*_, INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furn%sh two (2) co es of separate drawings.
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Desired Starg /o / Estimated Time for Completion +/ , ) y
Permit to be issued to / U Ol y J /
the holder of Drain Layer's License No. 7 Permit will expire thirty (30) days
after date of issuance. The undersigned Drain Layer hereby agrees to all the terms and
conditions set foyth in the permit and the reverse side the_reof_. #15-011cant has received
Town Permit No. and/or CHD Permit No. �f
Signed ( !'
l Licensed rain Layer
The above named Drain Layer has a valid license issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
o Engineering Department bate
Connection Charge Paid f4 a Permit Fee: Paid $ A -- "
Check Number
Issued by
Tax Office
INSPECTION
Date work started Q Z.3 Date completed Z -•
\_ Sufficient notification re4ived: t Yes No _T
dal Conditions
APPROVED:
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Construction Inspection Report
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Developer U Cantroclor
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Problem Arsos
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Street Time J; a 3
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Problem Areas
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