HomeMy WebLinkAboutDrain Layers Permit 9 Drake Court TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT NO 5904
R bra-. Cots+-1-- Z. -- t 8' �,� 19
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer name h re n o perform the work indicated below t
�b Z- ✓ at remises owned by Z&J' C-CZ4
whose address is Z Sr . (411 O/SO an to
Lay House Dra n, Repair ouse Drain, Lay Main, Other ,
for NL/ occupancy or use, with 5
Family Units , *with J acres.
Type of Sewage to be connected under this permit : SANITARY SEWAGE (�
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with S'
Show sketch of proposed work or furnish two (2) copi s of separate drawings .
SPECIAL CONDITIONS S h S7CGS 6
Desired Starting Date 'Z—`y' --.��_Estimated Time for Completion
Permit to be issued to TD /1 .� C..QU OS
the holder of Drain Layer 's License No . Z�pg p. 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. $" `f�j and/or
CHD Permit No. .
Signed
License ain yer
The above named Drain Layer has a vali license issued b the State of
Connecticut and has filed a satisfactory bond and insurance policy in the
name of the Town of South Windsor:
En 'ne ring Dept. Date
Permit Fee Paid $ a, .co Check Nu ter y,CIQI.0
Connection Charge Receipt No. qr�go Dated
Issued by
INSPECTION
Date work started Date completed
Sufficient notification rece ve : es No
Special Conditions
APPROVED:
nspector Date