HomeMy WebLinkAboutDrain Layers Permit 12 Drake Court TOWN OF SOUTH WI N DSOR
Q,F DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL j' n
DRAIN LAYER'S PERMIT ' 1�10 5907
Pursuant to written application, permission is hereby granted to the
Li nos d r n L ye nape he ,ei - to perform the work ijd�ic�a�ted_ b_pp, at
f t r�m i se
r"
whose address is -`. � } ' _ �, { I�^ S`n✓" to
Lay Uu e rain, Repair ' ous`e Drain, , Lay Main, .Other ,
for occupancy or use, with
Family Unit , with acres. —r-
Type of Sewage to +be connected under this permit: SANITARY SEWAGE
INDUSTRIAL WASTES ( ) , OR ( )'�
Connection will be made with Vvg -Est lo�rn
Show sketch of proposed work or furnIsh"two (2) copies ,o,f separate drawings.
i
SPECIAL CONDITIONS J ?7. 4:.1 i > r"� ,; S o :�o(.v�/1
Desired Starting Date Estimated Time for Eompletign
Permit to be issued to
r
the holder of Drain Layer ' s License N Permit will expire thirty
(30) days after. date of issuance. The urid!BfsLgag d Drain Layer hereby agrees
to all the terms and conditions set forth in the Ma�t ,and the reverse side
thereof. Applicant has received Town Permit No , and/or
CHD Permit No.
Signed t
Licen Dra Dyer
The above named Drain Layer has a val d 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 :
En ne ring Dept. Date
Permit Fee Paid $ j,� Check Nu er ��
Connection Charge Receipt No. Dated
Issued by
( M
INSPECTION
Date work started Date completed
Sufficient notificatlon received : yes No
Special Conditions
APPROVED:
Inspector Date