HomeMy WebLinkAboutDrain Layers Permit 145 Debbie Drive TOWN D f SOUTH -WI N DSOR
DVPARTMENT OF PUBLIWORKS
BUREAU OF POLLUT.IOR% ONTROL
DRAIN LAYER';S PERMIT 0 4424
CQL&1�_6u 4J() , 19
Pursuant to written application, permission is ereby rant to the Li c used Drain Layer
named herein to perfo the work indica5ed below at �) ��/ ef�j>;
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 ( ), INDUSTRIAL
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 Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer'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 rec ed
Town Permit No. and/or CHD Permit No.
Signed
i� censed bra n �.a er
1
The above named Drain Layer has a valid license issue by the State of Connecticut and
has filed a satisfactory bond and insurance policy in t Xname of the Town of South Windsor:
y Z .3 6
�tj ) Engineering Department Date
Connection Charge Paid � � JGc� Permit Fee: Paid $ :� • U J
t
Check Number
f ' Issued by
t Tax Office
INSPECTION
Date work started I2 `8 _& Date completed
Sufficient notification received: es No
Special Conditions
APPROVED: 'r l.tU Cl
Inspector i Date