HomeMy WebLinkAboutDrain Layers Permit 341 Abbe Road Extens TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT'
i
Pursuant to written application, permission is hereby granted to the'Licenged Drain Layer
named herein toyperform the work i icate below at fi
at premises owned by 1 / /? �f -'',% A,"_
_) '.
V /7.3%17.l teo x L r "? whose address is
La House Drain and to
y Repair House Drain, Lay Main, Other
for ; d �� occupancy or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE( , INDUSTRIAL
WASTES ( ), OR ( )
Connection will be made with
Show sketch of proposed work or furnish two (2`)+cUies of separate drawings.
1 3yT � � �� at
SPECIAL CONDITIONS
Desired Starting Date 2(- Estimated Time for Completion
P
Permit to be issued to (� �j L�E-��
the holder of Drain Layer's License No. ,,to 77 Permit will expire thirty (30) days
after date of issuance. The undersigned Drain Layer hereby agrees to all t e t s and
conditions set forth in the permit and the reverse side thereof. Applic received
Town Permit No. and/or CHD Permit No.
Signed J'i-'
i en a rain layer-"-,
The above named Drain Layer has a valid license issued by the St -ta a of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
--0471
Engineering Department Date ,
Connection Charge Pai � Permit Fee: Paid $
Check Number 3�
Issued by
Tax Office
INSPECTION
Date work started J Z� , 910 Date completed '"
Sufficient notification received: A000, Yes No
Special Conditions
APPROVED:
Inspector pate