HomeMy WebLinkAboutDrain Layers Permit 29 Carson Way TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL 0� ) DRAIN LAYER'S PERMIT No 5754
C�rSO�►wR y. Lo14 d
Z 19
Pursuant to wr.i-ten appA'a ion, pe iss s�/hereby grant o the
Licensed Dr 'n Layer named here to pe t m/ the n 'rk indicated bbee w at
at prem'is s owned by 17,,0f (� �
whose address is ' foY" . r and o
L y Hpuse ra n TRepa r House Drain, LJ n ther Oi7�lc�'
Family Uni th a
Type 'of ewage to be connected under this permit : SANITARY SEWAGE ,
INDUSTRIAL ES ( ) , OR ( )
Connection will be made with 119 ; L oteo C
Show sketch of proposed work cs Au sh two (2) copies of separate drawings.
PROUr� IJw4IS
SPECIAL CONDITION`S 05;4fio. C
Desired Starting Date Estimated Time for Com letion JJ
Permit to be issu d t , d --�'
the holder of Drain Layer''s� License No. B` (� Per t wfll expire thirty
(30) days after date of issuance. The undersigne DrairL 'Lalver 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 ✓
Licen d Dr n Layer
The abovenamed Drain Layer has a valid licen issu by the State of
Connecticut and has filed a satisfctory b nd and insurance policy in the
name of the Town of South Windsor ;` . /"
En in e g Dept. Date
Permit Fee Paid $ Chh77e-1ck umber
Connection Charge Receipt No. w Dated 2-1
Issued by
INSPECTION
Date work started Date completed_
Sufficient notific-a on recelveal -Yes No
Special Conditions /� /'�iy� �,y7►1srj mom /
APPROVED: / rl>
Inspector Date