HomeMy WebLinkAboutDrain Layers Permit 103 Benedict Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT L40:�tj Iq Nam, 46 8 1
1
Pursuant to written application, permission is er g anted to the L3*,cp-nsed Drain Layer
named herein to perfoW the work i fcata
d below at
at premises owned by whose address is
Oil and to
Lay House Drain, Repair House 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 ( ) 6 r�V C Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
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SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No. gl �J . 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, and/or CHD Permit No.
Signed
r
Licensed Drain 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 the na the Town of South Windsor:
>W 5 /y ,�-__,7
Engineering Departmen Date
Connection Charge Paid-'L������j 7 Permit Fee: Paid $ 06
Check Numberd _
p 1 sued by
Tax Office
INSPECTION
Date work started J O —dJ' Date completed 2.
Sufficient notification received: s No '
Special Conditions
APPROVED•
Inspeetor Date
:�R,zT
Ys" TbWN OF SOUTH WINDSOR
A, r
f� DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 46 8 1
1
Pursuant to written application, permission is erepy granted to the�Li ,ensed Drain Layer
named herein to perfoIT the work indicated below at {�'J 'j� ,� Z r C "1 �� � ..{�_
at premises owned by a r c� whose address is
and to
Lay House Drain, Repair House 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
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No. a: 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. and/or CHD Permit No.
Signed flu-, tnJ Q G ,
Licensed Drain. 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 the na the Town of South Windsor:
Engineering DepartmenY Date
Connection Charge Paid'�`1- ' `�� �j Permit Fee: Paid $ % j U 6
Check Number
TA sued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector pate