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HomeMy WebLinkAboutDrain Layers Permit 057 Austin Circle TOWN OF SOUTH WINDSOR u DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL ARAIN LAYER'S PERMIT s0 5850 19 Pursuant to written application, permission is hereby granted to the Li-- d 3 in Laye n ed herein to perform the work indicated b.elo at at�remise owned by r-ph whose address is $^$' a to Lay House Drain, Repair ous'e Drain, Lay Main, Other , for 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 5 Show sketch of proposed work or furnish two (2) copies of separate drawings SPECIAL CONDITIONS �S G / b,p 6otoo-) ,4 Desired Starting Date /©---7 Estimated Time for Completion Permit to be issued to the holder of Drain Layer's License Nc -ZOJR YO 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. Jigs 'and/or CHD Permit No. . Signed Licens Dra i Layer The above named Drain Layer has a valid iieense issue by the. S:tate of Connecticut and has filed a satisfactory bond and insurance policy in- the name of the Town of South Windsor: - \�\,\mot�-.--. i eering Dept. Date Permit Fee Paid $ 5 00 Check INMber Connection Charge Receipt No. _ Date 10 Issued by INSPECTION Date work started �- 2-g Date completed ® �9- 2 Sufficient notificaulon receive : Yes No Special Conditions APPROVED: -Zon - q, Inspector Date