HomeMy WebLinkAboutDrain Layers Permit 14 Drake Court t,;v.,Tv^r .. :': ✓'s �. -' `w ..ter
TOWN ` Of SOUTH W1 N DSOR
DEPARTMENT OF PUBLIC WORMS
BUREAU OF POLLUTION CONTROL
o 5867
DRAIN LAYER'S PERMIT N.
/O 19
Pursuant . to wri ten application, permission is hereby granted to the
Licensed Drain Layer name rei7 . n to perform the work indicated below at
45f2.V at premises owned by > f C 0nS .
whose address is"'`b S'g J i'ar vH-� an to
Lay House Drain, Repair fiou`se''Drain, Lay Main, _ Other�,�
4 for occupancy or use, with
{ Family Units, with _ - / acres.
Type of Sewage to be connected under this permit : "SANIJARY SEWAGE (. .
INDUSTRIAL WASTES ( ") s OR } ,,
Connection will be made with �
D� 3S Sew �
Show sketch of proposed work or furnish two (2) copi.es of'- separate drawings.
SPECIAL CONDITIONS o1w5 o I7P o �lv /
Desired Starting Date /Q-- 2 '7---9.z- ' Estimated: Time .for Completio-n
Permit to he issued to _3d bZ7 SS U
the holder of Drain Layer's License N Zpgg,3d' Permit will expire thirty
(30) days after date of issuance. `The undersigned DrainLayer hereby agrees
to all the terms and conditions set forth in the permit and .the reverse side
thereof. Applicant has received 'Town Permit No b 7 andIQr
CHD Permit No.
Signed C�
Lice ed D in Layer
The above named Drain` Layer has a, vali license issued by the State of
Connecticut and has filed a satisfactory bond, an_d insurance .pol,icy in the ,
name of the Town of South Windsor:
Enjlnaeering,. Dept Date
Permit Fee Paid $ Check Number
Connection Charge- Receipt No. 1-/ ��, ..Dated
Issued by ="
INSPECTION f.
Date work started �! �✓` � Date completed ytD 4'
Sufficient notification received: yes No
Special Condition 07
--
APPRO ED• }
Inspector Date .