HomeMy WebLinkAboutDrain Layers Permit 055 Austin Circle TOWN OF SOUTH WINDSOR
DEPARTMENT 'OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAXER'S PERMIT o 5848
19 572.-
Pursuant to written :application, .permission is hereby granted to the
Licens d' praf LZ;�.} ame. herein to perform the work indicated below_at
.��` / at premix s owned by „�Crj!'iS
whose a4 . ress is, .S a o
Zay House Drain Repair, ouse' Drain, Lay Main 0pher . ,
for r¢ f oc.cupandy or use, with
Family Units, with acres.
Type: ,of Sewa"ge to be connected under this permit : SANITARY SEWAGE
INDUSTRIA WASTES { ) , OR7.
)
Connection will be Made with a-/ `E
Show sketch of pY'oposed work or furnish two copies oi s•eparate drawings.
f j
SPECIAL CONDITIONS 0S� U f�f S /?p
9 d� a � s ly
Desired Starting. ;Date J - ?~9Z Estimated Time for Completion
Permit to be issued to , JD)"tY� Q. V -S
the holder of . Drain Layer 's 'License N 71pg1930 Permit will expire.' thirty_
(30) ;days' after ,date of i,ssu.anc.e. ' '.`The�.-undersigned Drain Layer ,hereby agrees'
to all the terms and,, conditions set forth in; the permit and the reverse side
thereof. Applicant 'has' rece''Ived Town .Permit No. and/or :
CHD Permit No:
Signed G
n aver
The above named Drain Layer has a: valid gicense4(/bra.i
ens.e issued by the State of
Connecticut and h:as .f led ,a satisfactory bond and insurance policy in- the .
name of the Town -of South Windsor:
�g eering Dept. Date -
Permit Fee Paid $ Check tuber
Connection Charge Receipt No. Dated.
Issued: by !U
INSPECTION cy
Date work started Date completed
Sufficient notification rece ve es No
Special Conditions
Inspector Date