HomeMy WebLinkAboutDrain Layers Permit 401 Abbe Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT - #
a.
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Pursuant to written application, permission is hereby gran e to the Licensed Drain Layer
named herein to perform the�/wo� rk indicated below at
at premises owned by �.;<'. h we /Y, ,ram whose address is
Lay House Drain, Repair House Drain; and to
Lay Main, Other
for occupancy or use, with
Family Units, with acres.
Type of Sewage to be connected under this perm't: SANITARY SEWAGE ), INDUSTRIAL
WASTES ( ), OR { ) �/j���• C, Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
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SPECIAL CONDITIONS �e
Desired Starting Date Estimated Time for Completion __ f :�
Permit to be issued to C �p
the holder of Drain Layer's License NO.c�fJ(,::;,ci1W . Permit will expire thirty (30) days
after date of issuance. The undersigned Drain Layer hereby agrees to all the terms and
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No. and/or CHD Permit No. 7 o 6 9,7/
Signed
Licensed Drain Layer
The above named Drain Layer has a valid licen� jisuedby the State of Connecticut and
has filed a satisfactory bond and insurance policyme of own of South Windsor:
AT
Eno ineer#1 epartment Date
t
Connection Charge Paid
g -� � c�x Permit Fee: laid $
4'rl�eckber
Issued by
. Tax Office /
INSPECTION ,
Date work started ®�� i Date completed
Sufficient notification received: j s No
Special Conditions
APPROVED: .-
nspector Date