HomeMy WebLinkAboutDrain Layers Permit 491 Ellington Road TOWN l OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYERS PERMIT
b o 5893
19
Pursuant to written application, permission is. hereby grant d to the
Licensed Dr i. La er n med herein to perform the work indicated below at
fin- ,Q :a.t premis s ocaned by
1
whose address. G:�' t�CC� =- and to
Lay House Drain, Repair House `Drain, Lay Main, Other ,
for / s _Kj�u,,,� occupancy or use, with
Family Units, nth 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 t (2)` co es of separate drawings.
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SPECIAL CONDITIONS
Desired St$xt ng Date s' Estimated Time, for Completion AC7q S
Permit to be 'issued to
the holder of Drain Layer 's License No ,�v'7� Permit wall i xpir=e thirty
(30") ':days after date of is$uance. The undersigned Drain Layer Hereby agrees:
to all' the .terms -and coriditioris set forth in the permit and_ the reverse side.j
:.:thereof.', , Applicant has received Town Permit No , a d/or j
CHD Permit., No d 0 1_0(5 .
Signedk-PI i
icen ed Dr n a
V.
The above. named D.xain Layer has a .valid 1 cense issued by t,h to of
Connecticut and has f1led` a satisfactory bond and insurance po c n the :
i ain,
;of the Town: of South Windsor: f
eZ 42, �{ `
r E eering Dept. Date" .
Permit Fee Paid $ Check tuber #' �
Connection Charge Receipt No. �b Dated' - �.
Issued by=- -
INSPECTION
elm
Date work started f� 1 Date completed . !
Sufficient notif ic2lMn recelvea; 4,2 es No
Special Conditions v
nspector bane.