HomeMy WebLinkAboutDrain Layers Permit 32 Elderberry Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRA ' Io 5873
IN LAYER'S PERMIT "
Pursuant to- written application, permission is hereby granted to the
Licensed Drin Layer named herein to er rm the work indicated below at
f �2 Gti —per� a "ises owned by 'em ✓ /
whose address is el YL-<IkL-1 k —t and to
Lay House Drain, Repair 'House` Drain Lay Main, -Other ,
for �f .�k..11 occupancy or use, with -
Family Units, with es.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ,
F INDUSTRIAL WASTES ( ) , OR
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS //� � � /0f/_ ,15E
Desired Starting Date [ Estimated Time for Completion
Permit . to be issued to . (,&3 t �i t ✓wv
the holder of Drain Layer's Lieense.' No. 20 2� 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 hats_ received Town 'Permit No, and/or
CHD Permit No.
S. e
- Licensed Drain Layer
The above. name.d Drain Layer has a valid 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 veering Dept. Date
Permit Fee Paid $ _oo Check Nu ber9 c>
Connection Charge Receipt, No. Y2
4(:> Dated
Issued. by 1 109 z
INSPECTION
Date work started Date ompleted ��''�U� 7i ' f �V
Sufficient notifica=io'o �iecely a: -'es No
Special Conditions
APPROVED:
Inspector Date