HomeMy WebLinkAboutDrain Layers Permit 2329 Ellington Road + TOWN OF SOUTH WI N DSOR
EPARTMENT OF PUBLIC WORKS
�f /!BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT NNO, 4631
n � J
`7 1911
Pursuant to written application, permission is hqTrebvjgFanted to the Licensed Drain Layer
named herein to perform the w rk ' aced b low
at premises owned by whose address is
and to
Lay House Drain, Repair House Drain, Lay Main, Other ,
for occupancy or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
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SPECIAL CONDITIONS
Desired Starting Date `I/p k-7 Estimated Time for Completion lr/. /�.77
Permit to be issued to S4 19S S 'nL S�F2✓IC=e`
the holder of Drain Layer's License No.C9 0 V '7 3 3 . Permit will expire thirty (30) days
after date of issuance. The undersigned Drain Layer hereby agrees to all the rms and
conditions set forth in the permit and the reverse side thereof. Applicant received
Town Permit No, and/or CHD Permit No. _
Signed ,
Licensed Dtao Lay
The above named 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:
Engineering Department Date
Conn tion Charge Paidq--9 6-? *,3: Permit Fee: Paid. $
Check Number
t
ssued by
Tax Offi e
INSPECTION ^�D
Date work started Date completed / tv
Sufficient notification received: Yes No �—
Special Conditions
APPROVED: _
Inspector Date