HomeMy WebLinkAboutDrain Layers Permit 30 Brookfield Street (2) TOWN Of SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
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DRAIN LAYER'S PERMIT N"2 5 4 9
19 .90
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform the work indicated below at 3O
at premises owned by ,/��i„ /0 ;fijl j�,� whose address is
and to
Lay House Drain, Repair House Drain, Lay Main, Other
for Via." ry erCiGJ/ occupancy or use, with
Family Units, with ,S' acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE O, INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
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Show sketch of roposed work or furnish two (2) copies of separate drawings.
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ell
SPECIAL CONDITIONS
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Desired Starting Date q- S ?p Estimated Time for Completion 2 g2 y f
Permit to be issued to hlt,. 13 f foh -2;7
the holder of Drain Layer's License No. Z by G 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 �� i
Licensed D ain 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:
41 -- 5y
Engineering Department Date
Connection Charge Paid Permit Fee: Paid $ ?S
Check Number 3 Z 7
Issued by
Tax Office
INSPECTION w✓
Date work started C�1C2 9 0 Date completed
Sufficient notification received: _�es No
Special Conditions
APPROVED: 10& _
Inspector pate