HomeMy WebLinkAboutDrain Layers Permit 76 Bramblebrae TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS'
BUREAU -OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT L' ® 5644
19&
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform hework indicated below at �� �/2fj�B�C ,¢� Meat premi� oymed whose address is
and to
Lay House Drain, 1/' 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 ,
��� Oj,s� Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
ee
SPECIAL CONDITIONS
Desired Starting Date / - Estimated Time for Completion
Permit to be issued to 'd /7 (f QyZrr
the holder of Drain Layer's License No. 0477 9 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 s' a hereof. Applicant has received
Town Permit No. and/or CHD Permit No.
Signed
Licensed Dro6n Layer
The above named Drain Layer has a valid licens s'sued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the na a of the Town of South Windsor:
/ l
7it
ginee ing D `p tment Date
/ UG
Connection Charge Paid '3 h 3��/ t � Pe Fee: Paid $
eck umber 3 U
Issued byJ Z2/
Tax Office cn
INSPECTION
Date work started O 2- Date completed 8'"2.7,,9 f
Sufficient notification received: Yes No
Special Conditions
Ot
APPROVED: ,_Z 7 r
Inspector Date