HomeMy WebLinkAboutDrain Layers Permit 549 Ellington Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
1 '1 BUREAU OF POLLUTION CONTROL
5872
o
5 DRAIN LAYERS PERMIT �
Pursuant to _written application, permission is hereby granted to the
Licensed Drain Laye.r .named herein to perform. the. work indicated below at
el—Ayg 0-7 at ..premises .owned by . 6'/LC .Zu7��z��
whose address - is and to
Lay -House Drain, Repair.-House . Drain, . -Laq Main, Other ,
for occupancy or use, with
Family Units, .'with acres.
-Type of Sewage to be. 'connected under this permit • SANITARY SEWAGE .(G...}_.__* .
INDUSTRIAL WASTES
Connection will be made with '
Show sketch of proposed ;work or -furnish two (�2) copies of -separate drawings.
SPECIAL CONDITIONS
Desired Starting Date /% 7 Estimated Time for Completion '
Permit to be issued to. /7/" <*� zFy�c X"
the holder of Drain Layers License No. 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 has received Town Permit No. and/or
CHD Permit No.. . :
Signed z�% S-_Zz��k
Lice sed r in Layer
-The above' named Drain- Layer has a valid license ,issu_ed ..by the. State of
Connecticut and 'has filed a 'satisfactory bond " and '.insurance policy. in -the
name of the Town- of South Windsor:.
_ ngineer.ing..Dept. Date.
Permit Fee Paid $ : Check 'Number,._-.
Connection Charge :Ript:ece No.' Dated'
_ x-
Issued by
INSPECTION
Date work started Date completed .
Sufficient .notifica on rece ve : yes , No
Special Conditions
AP
Inspector Date
. 1