HomeMy WebLinkAboutDrain Layers Permit 018 Cambridge Drive .,v 'K ;.w: �3t�'.��`3�,'l 'v''�i('v'�'�'etiA�y'c�Cssere:. . -•+Aet�xa, x.:
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 1`�No. 4846
I
Pursuant to written application, permission is he reb y
ly rant d to .the Licen ed Dr in Layer
named herein to perform the Work i-gdica ed below at A �� �;�,�(�'F�� �� �,
at premises owned by 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 #ill 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 t
de-o-&
the holder of Drain Layer's License No'' `p' 2 . Permit wi3O expire thirty (30) days
after date of issuance. The undersigned Drainlifyer hereby agreesi.to all the terms and
conditions set forth in the permit and the reverse side :thereof. Applicant has rec 'ved
Town Permit No. and/or CHD Permit No.
Signedall
k 5 cense rai r
T
The above named Drain Layer has a valid license issued by the State of Connecticut and
has filed a satisfactory bond and insurance polic the name of the Town of South Windsor:
Engineering Department Date
Connection Charge Paid /CjG G}r) Permit Fee: Paid $ : :
Check Number /f
r '4 f X/k ti Issued by
Tax Office
INSPECTION
Date work started U ` �� Date completed
Sufficient notification received: Yes „l No
Special Conditions
APPROV" �-f6
Inspect-or Date