HomeMy WebLinkAboutDrain Layers Permit 46 Carson Way TOWN OF SOUTH W NDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
} DRAIN LAYER'S PERMIT °-;:�0 5900
19
Pursuant to written application, permission is hereby granted to the
I Licensed Drain Layer nam d herein to perform the work indicated below at
6f#S-3 e"So ,� at premises owned b � �
w_. whose address .is S' o a to
4 Lay House Drain, Repair Hotrse Drain, Lay .Main, Other_ !,
£oril� occupancy or use, with. S/
Family Units., with acres.
Type ,rof Sewage to be connected under this permit : SANITARY SEW AG:E (1�'
INDUSTRIAL WASTES )' -
Connection will be made with I -ehJ`er
t -
; iow sketch of proposed work or furnish two (2) copies of ' separate drawings.
SPECIAL CONDITIONS cS S lJ
Desired a`ltart3ng Date Estimated Time for Completion -
ermit S to be issued to L1 ,, c�-PSG
the ,boo, o£ Drain Layer's License No. Z� 3CJ Permit will expire;-thirty
a s' after -date of is?s_uance. The und' xsigned Dr•ein Layer Hereby'. agr;'es
t;o alh the .t' ro' i is and conditions set forth in the permit and the reverse side
theredf. ' Applicant has received Town Permit No. S100 and/or
CHD Permit No.
Signed )
Licen d D in Layer
- The above named Drain Layer has a valid license. isl .= ed by the State of
Connecticut and has filed 'a satisfactory bond and insurance -policy in the
name of the Town of South Windsor:
gi eering . Dept•, Date
Permit Fete Paid $ 25 ,00 Check umber
Connection Charge: Receipt No. . Dated
�f
Issued by
INSPECTION -
Date work started Date completed .-'Q
Sufficient notificaf•iTn received : p— yes No r
Special Conditions
APPROV 2%?—!u�.
InsrpeFtor Date