HomeMy WebLinkAboutDrain Layers Permit 32 Foster Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT � �._ 'F-Z 2 5206
19
Pursuant to written application, permission is hereb ranted to the License Drain Layer
named herein to perform pe , rk indicated b low at . �`" �' i
at premises owned by s
=� df whos ddress is
Lay House Drain, Repair. House Drain, and to
for Lay Main, Other
Famii Units with occupancy or use, with
y � acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (✓J, INDUSTRIAL WASTES O, OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
p�21 VC.ro )-9,e0`�
,o
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No.cl'� -� a,,,r
o C . 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
Licensed Drain Layer
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 e me of Town of South Windsor:
C; r
Engineering Department " Date
Connection Charge Paid 1 - - ^1
a.
-- -_ - -`��- - Permit Fee:- Paid-
Check Number
_,V
Issued by
Tax Office
INSPECTION
Date work started natQ " mp1-"ed _
Stifficient notification received: Yes
No
Special Conditions
APPROVED:
Inspector Date