HomeMy WebLinkAboutDrain Layers Permit 73 Alison Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT NO 5749
19
Pursuant to written application, permission is hereby gran ed to the
Licensed Drain Layer named herein to perform the work in cate below at
at premises owned by ��
whose address is "� 3 K'C J fOA- Az and to
Lay House Drain, 'Repair House Drain, Lay Main, Other ,
for 41)(,—V occupancy or use, with
Family Units , with ze2acres .
Type of Sewage to be connected under this permit : SANITARY SEWAGE (�
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with 4
Show sketch of proposed work or furnish two (2) copies of separate drawings .
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1
SPECIAL CONDITIONS
Desired Starting Date �,� Estimated Time for Completion ;L A,��4Vc
Permit to be issued o Co u<:� C�
the holder of Drain Layer ' s License No. _o' Permit will expire thirty
(30) days after date of issuance. The undersigned Drainydh
ereby agrees
to all the terms and conditions set forth in the permit reverse side
thereof. Applicant has re eived Town Permit No. d/or
CHD Permit No.
Signed
cens d ra Layer
The above named Drain Layer has a valid license i by the State of
Connecticut and has filed a satisfactory bond and insurance policy in the
name of the Town of South Windsor:
En in eying Dept. Date
Permit Fee Paid $ `5 Check N�, ber ^�
Connection Charge- Receipt No. / Dated 9Z
Issued by
INSPECTION
Date work started 9 Z Date completed
Sufficient notification received ; _� es No
Special Conditions
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APPROVED % y - /3 :22
Inspector Date