HomeMy WebLinkAboutDrain Layers Permit 121 Commrce Way .. ..w:•a.. ,... , .. �-.-r- -;. .,=.i. non.-n h ;.-I".A ..;l+Ti"T'
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT J `j 98
77
Pursuant to written application, permission is hereby grante ?to the License. Drain Layer
named herein to perform Pe w kin icated bel w at G��
at premises owned byci whose address is
Lay House Drain, Repair House Drain, and to
Lay Main, Other
for occupancy or .use,. with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (hj,fINDUSTRIAL
WASTES ( ), OR ( Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date —/ "v Estimated Time for Completion
.Permit to be issued to v L _ :�d✓."T
the holder of Drain Layer's License No. -ZQ7 7 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 s'de thereof. Applicant ha received
Town Permit No. and/or CHD Permit No.
Signed s j
Licensed, ain Layer
The above named Drain Layer has a valid liceb/eissued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
y Engineering Department Date
Connection Charge Paid 2 7, c//O Permit Fee: Paid $ ✓.�� � `� J/��i
Check Number
Issued by ��� G /
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED: od
Inspector pate