HomeMy WebLinkAboutDrain Layers Permit 282 Abbe Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT5283
Pursuant to written application, permission is hereby-g�ante to t e Licen d Drain Layer
named herein to. perform e work indictedp below-atA
at premises owned by -
whose address is-
Lay House Drain, P Repair House Drain, La Main and to
for Y , Other
Family Units, with us
occupancy or e, with
acres.
Type)ofSewage to be connected under t 's,pe t: SANITARY SEWAGE (L}; USTRIAL
WASTES O
, /
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No.
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.
f Signed
�v
Q� Licensed Drain 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 a name of the To of South Windsor:
Engineering epartment
Date
Connection Charge Paid J6V "'6101,
G v Permit Fee: Paid $ /6
Check Number 0 7
-- Issued by
f is e
INSPECTION
Date work started 2. —/�J Date completed 2,
Sufficient notification received: Yes No
Special Conditions
APPROVED:
d��nspect Date