HomeMy WebLinkAboutDrain Layers Permit 205 Debbie Drive (2) TOWN OF SOUTji WINDSOR
DEPARTMENT OF DUBLIC WORKS
BUREAU OF POLLUTION CONTROL t
} DRAIN LAYER'S PERMIT 4651 s
19
Pursuant to written application, permission is her b granted—to the Lice ed Drain Layer
named herein to perform-the w kid c to belo at,
;
at premises owned by iahose a:ddre"ss is
and to
Lay House Drain, Repair House Drain, Lay Main, Other ,
for occupancy r use, with
Family Units, with a"es.
Type of Sewage to be connected under this permit: SANITARY S ' AGE p ( `), INDUSTRIAL �-
WASTES ( ), OR ( ) Conne r
ion wiA 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 received
Town Permit No. and/or CHD Permit No.
Signed -. 4-1
Licensed Dr in.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 in the name of the Town of South Windsor:
Engineering Department Date
Connection Charge Paid � � ,� K J Permit Fee: Paid $ �5� �.
Check Number ` U 610 1 a
Issued by �.dt
Tax office
INSPECTION
Date work started 6 ^�6''87 Date completed � l6^Brl
Sufficient notification received: _ CK Yes No
Special Conditions
APPROVED:
Inspector Date