HomeMy WebLinkAboutDrain Layers Permit 264 Foster Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT g° 5-2 0
19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform the work indicated below at (p!� f-057 e Z 57--
at premises owned by ZZ /
¢ F0 STelZ S r- whose address is
Lay House Drain, x Repair House Drain, Lay Main and to
for ��,�� F Other
Family Units, wit acress..F is y occupancy or use, with
h
Type of Sewage to be connected under this permit: SANITARY SEWAGE
WASTES QC), INDUSTRIAL
( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
If VG
SPECIAL CONDITIONS
Desired Starting Date t/ / Estimated Time for Completion
7 /Z
Permit to be issued to t �U�L/rC--I -�1k�P- 567--P/c
en C
the holder of Drain Layer's Licse No
u � 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. App�i�'nt ;has receied
Town Permit No. and/or CHD Permit No.
/`
Signed
L' en ed Drain 1,4,r
The above named Drain Layer has a valid licens is ed by the State of Connecticut and
has filed a satisfactory bond and insurance policy n t name of e9Town of Souo Windsor:
_ En ineeri �partmen Date
Connection Charge _Paid ! 541 - S- {ermt- Fee:`-Paid-$ - -
ec NumberL.
Issued b
y ,.
Tax Office
INSPECTION
Bate
Date work started 7�- / ��cj' J -eemp3eted
Sufficient notification received: Yes
No
Special Conditions
APPROVED:
Ins ctor Date