HomeMy WebLinkAboutDrain Layers Permit 30 Beechwood Lane t
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
so DRAIN LAYER'S PERMIT 56
1>�.�-f cps f ,�. - 19
Pursuant to written application, permission is hereby ranted to the `Licensed Drain Layer
named herein to. perform the work in below a`t G C ; j='
at premises owned by whose address is
and to
Lay House Drain, Repair House rain, Lay Main, Other ,
for occupancy or use, with 1
Family Units, with cres.
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) copies of separate drawings.
L- 4,>
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion o-_ f �
Permit to be issued to n
the holder of Drain Layer's Licens No. Permit will expire thirty ( 0) days
after date of issuance. The unde signed Drain Lay r hereby agrees to all the t rms and
conditions set" forth in the permit and the reverse side thereof. Applicant has received
Town Permit No. and/or CHD Permit No.
Signed
Licensed Drain L er
The above named Drain Layer has a valid license issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
IPC� Engineering Department Date
Connection Charge Paid ) Permit Fee: Paid
Check Number
Issued by ,
Tax @ffice
INSPECTION
Date work started �:�7 Date completed �— 2T- 9
Sufficient notification received: _�� Yes No
Special Conditions
APPROVED:
Inspector Date