HomeMy WebLinkAboutDrain Layers Permit 002 Austin Circle TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT '} 0 5 7 9 9
76
Pursuant to written application, permission is ereby granted to the
Licensed ra Laye -named rein to. perform the work indicated elow t
t%�= at premises ow ed y
whose ad ress fd`"is Sa.
a ro
Lay House Drain, Repair o e Drain, Lay Main-F . Qther ,
for occupancy or use, with
Family Units , with 1,/ acres.
Type of Sewage—to7Tbe—connected under this permit : SANITARY SEWAGE (t�
INDUSTRIAL WASTES ( ) , OR' (
Connection will be made with 3 3 ,o
Show sketch of proposed work or furnish two (2) copies of separate drawings.
S �trSPECIAL CONDITIONS p � �
Desired Starting Date ZZ Estimated Time for Completion 2
Permit to be issued to ,� M-T 6tis7--
the holder of Drain Layer 's License No. -Z�7S S3C>.. Permit 11 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 yfB 7 and/or `
CHD Permit No.
Signed "
icens d T
n Layer
The above named Drain Layer has a val licens issby the State of
Connecticut and has filed a' satisfactory b nd -and insurance policy in the
name of the Town of South Windsor:
tt gin a ng Dept. . / Date
Permit Fee Paid $ Z e00 Chec umber ��p(0
Connection Charge Receipt No. 4-1 Dated 9 Z
Issued by
INSPECTION
Date work started Date completed
Sufficient notifica on rece ve : Yes No
Special Conditions
APPROVED:
Inspector Date