HomeMy WebLinkAboutDrain Layers Permit 060 Carriage Drive �, .. ::. f..;:;.;rr.�.Hc• �;��.N�"' ter. -..r'ty:... ., .. ., .
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 5 6 6
OCiyQER a , 1991
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform the work indicated below at Gy o/a,
at premises owned by :o11A ,j, V LiweN �(�" /t/tJ
1 � whose address is
GD CA22r-16z i),2, 5"'ou 16v1)SW cif 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 fv)^, INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
a
SPECIAL CONDITIONS Mq/,/1'-owx) Clz �a���iv.+! rJ fKtS ii,J G (SPA ,
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No. 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. l
Signed J11
• 1 t)ql c OtNNe"�z
The above named Drain Layer has a valid license is ed bI)ry the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
0 2
Engineering Department D to
Connection Charge Paid Permit Fee: Paid $
Check Number
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED,•
Inspector Date