HomeMy WebLinkAboutDrain Layers Permit 46 Beechwood Lane TOWN OF SOUTH WI N DSOR
rQ/ DEPARTMENT OF PUBLIC WORKS
c , BUREAU OF POLLUTION CONTROL
t DRAIN LAYER'S PERMIT ,: rc19
LAU
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform the work indicated b low at L S
at lremises owned by L�r ( --
a 17 v") cfco). whose address is
._ ex j . _-1 r� r and to `
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Lay House Drain, Repair House Drain, Lay Main, Other ,
for •.a /�„ f ;� / ;1, occupancy or use, with /
Family U its, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (/), INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch 2f proposed work or furnish two (2) copies of separate drawings.
l
SPECIAL CONDITIONS
Desired Starting Date /% Estimated Time for Completion J/j
Permit to be issued to � /;�'G,c.� i /e f,ez t - c
the holder of Drain Layer's License No. 2 (o Permit will expir thirtyf(3O) &ys
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. and/or CHD Permit No.
e
Signed
Licensed D a Layer
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:
z/p Engineering Department Date
Connection Charge Paid '>: ' Permit Fee: Paid $ ~
Check Number C;_. < , -
Issued by --- � /
Tax Office
INSPECTION q
Date work started ( � Date completed 9�
Sufficient notification received: es No
Special Conditions
APPROVED;
Inspector Date