HomeMy WebLinkAboutDrain Layers Permit 30 Carson Way TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL777
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DRAIN LAYER'S PERMIT 0 `�
v ICJ , 19
Pursuant to written application, permission is her y granted to the
Licensed Drain Layexr na eedd herein to perform the work indicated below at
l� (i i 8la46S LD- 7 ( at�o��p, i s owned b - U �
whose address is �` lCCl'. 1J., C� and to
Lay House Drain, Repair ouse Drain, Lay Main, Other ,
for St n Tie occupancy or use, with
Family Uni s , with 3JU acres
Type of Sewage to be connected under this permit : SANITARY SEWAGE ( ,
INDUSTRIAL WASTES ( ) , OR
Connection will be made with � Lll �
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL COND'ITIONS L-e_ A</l� 7 0,o5r /7 121aU�13�C�/'1-7�20—
Desired Starting .Date Estimated Time for Completion ..5.
Permit to be issued to �C,� rlyluGt
the holder of Drain Layer' s License No. + 300 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 . y`/"7 anal/or
CHD Permit No.
Signed
L cen d Dr in Layer
The above named Drain Layer has a val licens issued by the State of
Connecticut and has filed a satisfactor b nd and urance polcy. in the
name of the Town of South Windsor
n ine r g Dept. ,p Date
Permit Fee Paid $ S��UU Chec umber o . 34-
Connection Charge Receipt No. 4 ated
Issued by
INSPECTION 77
Date work started - OZ-q'Z-Date completed" �► 3�7L
Sufficient notific-a on receive-d Yes No
Special Conditions
APPROVED: Ag 113/�>
Inspector Date