HomeMy WebLinkAboutDrain Layers Permit 55 Dower Road ,. . ,... .... ._.. ..-..;K ,7`�`eg-' E�;F�� '"^°ri�'g�'Y�.�3'k•�`�"s�'�.- r.. -
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT '' 5 G
J U /f/ , 19,,
Pursuant to written application, permission is hereby gra ted to tie Licensed Drain Layer
named herein to perform the work --- ic�t(. below at .1.5 :r- I{
at premises owned by a , � ( r r� (1 whose address is
5S )�J�,-��,4 and to
Lay House Drain 1XI Repair House Drain, Lay Main, Other ,
for , �({, ,, r, t occupancy or use, with
Family Units, with 1 acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (-14), INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
_Show sketch of proposed work or furnish two (2) copies o epara drawings.
N
SPECIAL CONDITIONS Jon-t,
Desired Starting Date 1 ju. y I Est' ated Time for Completion S.ju J
Permit to be issued to G, y, Vjt: —
the holder of Drain Layer's License No. ;LCj'f�)1 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 permi
t t and the reverse side thereof.. Applicant has received
Town Permit No. and/or CHD Permit No.
• r /
Signed � _12x,,�_0_._-
Licensed Drain Layer
The above named Drain Layer has a valid license issue by the State of Connecticut and
has filed a satisfactory bond and insurance policy .i�l, the ame of t:h Town of South Win sor:
ng neeri�g epartment Date
Connection Charge Paid Permi Fee: Paid $ 1
C ec1d Number / .3l
n
Issued by
Tax Office i
INSPECTION
Date work started 7—/c,* 9' / Date completed 7,/g—g/
Sufficient notification received: Yes No
Special Conditions
APPROVED:
nspector Date