HomeMy WebLinkAboutDrain Layers Permit 44 Cheshire Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT ? 3935
19 6L_
Pursuant to written application, permission is hereb granted to Oe Licensed Drain Layer
named herein to. perform the work in below-at
at premises-owned by Y- whose address is
and to
Lay House r7aiin-;`T Repair -HooII'u-se_� Rrai'`; Lay lain, other ,
for occupancy or use, xtth
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( INDUSTRIAL
WASTES ( ), OR -( ) Connection will be made with
r!:77 1 '
Show sketch of proposed work or furnish two (2)` copies of separate drawings.
SPECIAL CONDITIONS -- -
Desired Starting-Date Estimated Time for Completion
Permit- to .1Se issuid'tg
the holder of brain�Layer 1.s`license No. 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/o:rCHD Permit No.
Signed
Licensed Drain Layet
The above named.'DraiA Layer has 'a valid license' issued by the State'of Connecticut and
has filed a satisfactory bond, anti insurance, policy ,iit the name of the Town of South Windsor:
Engineering Department Date
Connection Charge Paid Permit `Fee: Paid $
Check Number 126b-z2 .3
Issued by
W ,�x1,Q 'ff. e/ , t c Q✓
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date