HomeMy WebLinkAboutDrain Layers Permit 3 Drake Court TOWN OF SOUTH WINDSOR
DEPARTMENT OF RUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMITo 5896
19
Pursuant to written application, permission is hereby granted to the
Licen a �D �a 'n. Layer named. herein to perform the work �tid3c.a e below t %
at pr-emises owned. by/ -���5" ,
d,
e dress is g 0�. , �If 4td a I to:
Lay House Drain, Repair Ouse lorain, Lay Main, Other ,
for ' occupancy�or use, .wit
Family ,-, es.
fF X D"CIG- -I
Type of/ S ,a a to' c nt��d'1� k`7rs �
P�. Rom'''S�`Efn1AG E
INDUSTRIAL WA rI •�,` ,
( O fit. `( �Connection wi 1 b�e m' a d'e w�yp , S� '/,J Zoe 1'% '
Show sketch of propose;xt voo''rk or furnish two (2)"'copies of separate drawings. ,,✓'
V
SPECIAL sn4d /� S f'�r/ '/ el`'
Desired Starting' Date Estimated Time for Completion /Pr1G
Permit to be issued to U ,
the holder of Drain Layer!s• L ce,;' N e gJ' r ;i t
(30) days after date of assuu�,�_n 'T a undersigned Drain 'Layer'" hereby
to all the terms and condition ce orth in the permit and the reverse '6U
thereof. Applicant has Y'eceived Towniit C2 -$► a;nd/or
CHD Permit No.
Signee&&
icen d Dr n Layer
The above. named,-Dr•ain' Layer has . a val license is the State of
Connecticut and has filed,, a sat-isfactory bond and insura o icy in- the
name of the Town of South Windsor:
Engineering. ,:D :pt. te .
Permit Fee Paid $ / Check.'Number Oy5O1
Connection Charge-Receipt No. Dated
Issued by
INSPECTION
Date work started ` - .93 Date completed
Sufficient notifica on rece ve :;C,�-Yea No
Special Conditions
APP
Inspector 1 Date