HomeMy WebLinkAboutDrain Layers Permit 48 Carson Way TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL c
DRAIN LAYER'S PERMIT I'M `����
rG , 19
Pursuant to written application, permission is hereby granted to the:'
License Drain Layer named herein . to perform the work indicated below at
S 1 O at premises owned by
whose address is le o and to
Lay Hous rain, V Repair H use Drain, Lay ffai_n, Other
for occupancy or use, with .
Family LVnits , with N acres .
Type of Sewage to be connected under this permit : SANITARY SEWAGE K) ,
INDUSTRIAL WASTES ( ) , :.OR ( )
Connection will be made with DR 7 S-C �✓ / G S
Show sketch-'of proposed work or furnish two (2) copies of sepa ate drawings.
SPECIAL CONDITIONS S HP r ea 6122h 4V2-s' O //01A) �
Desired Starting Date timated Time for Completion DA9
Permit to be issued to TT-C) ✓1 ZcLe1 L1 eS
the holder of Drain Layer's License No. 20 CQ Permit will expire thirty
(30) days after date of issu,ance. The undersigned Drain Layer hereby agrees
to all the terms and conditions set forth in the permit. and the reverse side
theregf. Applicant has received Town Permit No. and/or; .
CHD Permit N'o.
Signed
?dand
ce ain Layer
The above named Drain . Layer has a valin@, , issued by the State of
Connecticut and has filed a satisfactory bo insurance policy in the
name of the Town of South Windsor : -
IC).00 Cash E' a ring Dept. Date
Permit Fee Paid $ /�•cUC� Check Nu r / 06 �)U
Connection Charge Receipt No. Dated
Issued by
INSPECTION
Date work started Date completed -g/
Sufficient notifica on rece ve es No
Special Condition
APPROVED* , ?,30,
nspector Date