HomeMy WebLinkAboutDrain Layers Permit 29 Commerce Way - .'?
OWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS .
BUREAU OF POLLUTION CONTROL
TT
DRAIN LAYER'S PERMIT 1�Nd, 4440
19�c?
Pursuant to written application, permission is h r y granted to the Licensed Drain Layer
named herein to. perfoN t e work 'ndicated elow,a
at premises owned by whose .address is
and to
Lay House Drain, Repair House Drain, Lay Main, Other ,
for occupancy or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE V-1' INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
S1�/7 -3 5 y L
Show sketch of proposed work or furnish two (2) copies of separate drawings.
��Mry�t,.Gt wAy
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion /i- G -�P
Permit to be issued to XIF- 151-7rr6 c /Z 25,X
the holder of Drain Layer's License No. r_7�13 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/or CHD Permit No.
Signed �.�
Licensed Drain Layer
The above named Drain Layer has a valid license issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy�K-
inhe name of the Town of South Windsor:
:jam/ Engineering Depar ent Date
Connection Charge Paid�I "`, Cb -(U;;.,).._
) Permit Fee: Paid $ / ,� i✓!
l Check Number j'��_.{ #; ,�._� ✓(� ! r �' '`R- Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date