HomeMy WebLinkAboutDrain Layers Permit Deming Street - Part TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT " NO 5798
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Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
_ 0!!� T t premises ;owned by MWAI 1= S'OuTy yt///Vj-w
whose address is / D 6'94/L/A/ffA/ )VJ, - S(W r llW,/Jy and to
Lay House Drain, Repair House Drain, Lay Main, Other
for � /iT&y L, ya, t
occupancy or use with 17
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (Aj ,
INDUSTRIAL WASTES` ( ) , OR ( )
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of arate wings.
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SPECIAL CONDITIONS �� �ti4 T= TU -.�N�J�Z oti 7)
Desired Starting Date Estimated Time for Completion.
Permit to be issued to
the holder of Drain Layer's License No. a 4 9 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. bo' d a_nd i surance policy in the
name of the Town `of .South Windsor :
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g n e ng Dept. Date
Permit Fee Paid $ NU AJ(= Check kdmber
Connection Cha a Receipt No., ated
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TU 1�EthD i�`1 �tAiL'�' Co2,cJt�S Isawed by
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INSPECTION
Date "work started Date completed
Sufficient notification receive s No
Special Conditions
Inspector Date
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