HomeMy WebLinkAboutDrain Layers Permit 37 Bridle Wood Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT , 4676
6
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Pursuant to written application, permission is h reb�y gran ed to -the Lice s d Drain Layer
named herein to perfo th work indicated b l�w at � ' �� , Gar Aj ��r p- � -
at premises owned by ',(, , l U t ;Z ,[ !, y��,,/,� t_�� 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
f
Show sketch of proposed work or furnish two (2) copies of separate drawings.
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SPECIAL CONDITIONS
Desired Starting Date Estimate&-Time for Completion
Permit to be issued to _J :� ' -• •f
the holder of Drain Layer's License No. ,f = =,L, 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
a �
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 in the name- of the Town of South Windsor:
En`gineering� Department Date
Connection Charge Paid � J`� �; `j Permit Fee: Paid` LJ
Check Number , V
Issued by
Tax Office
i�
INSPECTION
Date work started 15 / O Date completed vzbko
Sufficient notification r ceived: Yes No
Special Conditions AVJ
APPROVED: _
Inspector pate