HomeMy WebLinkAboutDrain Layers Permit 053 Cambridge Drive 'r`a `� :SSn7's3e' .�, .F.:. t" -.�` t�` F � � i-. .i'r. .r.: •?-_ !"rvl: n, ti. }...
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TOWN OF SOUTH Wi N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT X0, 4810
9iD
Pursuant to written application, permission is �ereby gran d_ to// t Licensed Drain Layer
named herein to perfo the ork in�icate below at '� �Q rnl113
at premises owned by 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•;3EWA0E ( ), 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 4fCbi,!S i
the holder of Drain Layer's License No. Z 0.$Z9 Permit will expire thirty (30) days
after date of issuance. The undersigned Drain Layer hereby agrees to all the to s and
conditions set forth in the permit and the reverse side there Applicant has ceived
Town Permit No. and/or CHD Permit No.
Signed
icensed Drai7onnecticut
er
The above named Drain Layer has a valid license issued by the State of and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
Engineering Department Date
Connection Charge Paid L�/ .°j Permit Fee: Paid $
rrCheck Number P 10 (j
Y
jLIssued by
i
Tax &fice
INSPECTION
Date work started _-/0 ='�7 Date completed 8 7
Sufficient notification received: _� Yes No
Special Conditions
APPROVED:
Inspector Date