HomeMy WebLinkAboutDrain Layers Permit 59 Bridle Wood Road -z.•.,.. .., �.s„ .�',a�"' 4 v"...�n•P" _�..«: s�•r. {.'sts ..1,�•*,:uR �i:.z..s'.4 � ..>�¢-T-=,sue— .. .,.
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT Xo, 4439
19
r
Pursuant to written application, permission is hereb� granted to the Licensed Drain Layer
named herein to perform the work indicated below at
at premises owned by �;:7� �Lt� �� tiL �' ., a.� Q 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) copi s of separate drawing.
SPECIAL CONDITIONS
Desired Starting Date /} Estimated Time for Completion
Permit to be issued to Zl/YL�'L
the holder of Drain Layer's License N . Permit will e ire th-irty (30) days
after date of issuance. The undersigned Drain Layer hereby agrees to a4 he terms and
conditions set forth in the permit and the reverse side thereof. AppUt nt r C iev
Town Permit No. and/or CHD Permit No. J._�
Signed-!X
Licensed rain Layer
The above named Drain Layer has a valid license issue by the State of Connecticut and
has filed a satisfactory bond and insurance policy i the/name of the Town f South Windsor:
Engineering Department Date
Connection Charge Paid ��(,)D 'L' 6 Permit Fee: Paid $ /. j U
Check Numbers/�.
LL Issued by
Tax Office
INSPECTION
Date work started 1114/ Date completed
Sufficient notification received: es No
Special Conditions
APPROVED: %:> T a 177l-
Insp�e 6t or. ate