HomeMy WebLinkAboutDrain Layers Permit 006 Austin Circle TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
' o 58 95
DRAIN LAYER'S PERMIT iY'"N
Pursuant to written application, permission is hereby granted to the
Li c nse Dra.' L yer named herein to perform .the work indicated below at
/ C at premises owner} by GGh S
whose dress ,is S02 ✓. anAw to
Lay House Drains, Repair 1Wdse Drain, Lay Main, Other ,
for occupancy or use, with S /moo
Family Units , w'ith T6 acres .
Type of Sewage ,to be ,compected under this permit : , SANITARY SEWAGE
INDUSTRIAL WASTES ( )', "OR '( )`=
Connection-will-. be made with 1)� �� �" S`,e�zo
Show sketch of proposed -work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS andplap /
CS `o
o
Desired Starting- Date /- 5/_.��r Estimated Time for Completion /
Permit to be issued` "toy J,7 �'q c C> S
the holder of Drain Layer's License No. Zo$'6 30.. Permit will expire thirty
(30) days after date of is`su.ance. The undersigned Drain Layer hereby agrees ..
to all the terms and conditions set forth in .the permit and the revers side
thereof. Applicant has 'received `'Town Permit No . and/or
CHD Permit No. ,
Signed
Licen d bra ayes
The above named Drain Layer has a vali license issu by the State of
Connecticut and has filed a satisfactory bo d and insurance policy in the
name of the Town of South Windsor
_ Engineering Dep:t. Date
Permit Fee Paid $ 5- Check Number D yy;�--"�
Connection Charge Receipt No. Z Dated
Issued by
INSPECTION
Date work started f 7 - % Date completed 7,
Sufficient notification receives; tomes No
Special Conditions
.01
APPROV
Inspector Date