HomeMy WebLinkAboutDrain Layers Permit 15 Carson Way TOWN .. OF SOUTH WIN DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT No 5718
19 T2
Pursuant to written application, permhtssion is hereby granted to the
Licensed Drain Layer nam d h ei to perform the work indicated below at
L� r r. t premises owned by J,' S
whose address is 6 F l , 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) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date -gL- E times e� Time for Completion
Permit to be issued to 2
the holder of Drain Layer's License No, oP 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
Licensed Drain 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:
dg neering Dept. Date
Permit Permit Fee Paid $ --*
� Check Number l0� 5 1
Connection Charge Receipt No. 6L_-zd Datedir
Issued by
INSPECTION
Date work started �� �Z, �92. Date completed
Sufficient notification receiv" ea: Yes No
Special Conditions
APPROVED:
nspect r Date