HomeMy WebLinkAboutDrain Layers Permit 88 Dart Hill Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
r BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 5 J
19�l �
Pursuant to written application, permission is hereby ranted to the Licensed Drain Layer
named herein to perform the work indicated below at. Dp,;2 11 1-� t L 'k?,
at premises owned by C,LI irYo i2- rs 4-4r_1L_ whose address is
,u + A�i 14,L-�,, � 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, INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
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SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to C- � ' S G d 7 (�,o z G ,
the holder of Drain Layer's License No. O Kq,$-'/ . 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
License Drain Layer
The above named Drain Layer has a valid licens is ed by the State of Connecticut and
has filed a satisfactory bond and insurance policy t I name of Town of South Windsor:
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J/ `Y r En inee in epartment Date
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Connection Charge Paid yU -y J er t ee: Paid $ S OCR
Ch c�k Number
7
Issued b ��
Tax Office
INSPECTION
Date work started 3 ' Date completed /
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date