HomeMy WebLinkAboutDrain Layers Permit 290 Foster Street op TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 1 N2 5651
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Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform the work indicated below at a?o
at premises owned by Pp,�L e l� STD S7-
0 Fo S7VlZ whose address is
`S T and to
Lay House Drain Repair House Drain, Lay Main,
for Other
Famil Units with occupancy or use, with
y � acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE f�, INDUSTRIAL
WASTES ( ), OR ( )
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date �� 91 Estimated Time for Completion
20
Permit to be issued to 7jfyLr &j �E-
the holder of Drain Layer's License No. g,.T 7
sgd-
, Permit will expire thirty —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. Appl' ant has r eived
Town Permit No. and/or CHD Permit No.
Signed
L' a sed Drai 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 the name of the Town of South Windsor:
1 L�Engin Veeri g Department ate
Connection Charge Paid--W!�()961 - Permit Fee: Paid $
Check Number
[g-q
Tax office Issued by
INSPECTION
started Date work s
- — --9 . C3 - T Date completed f�—Q 3 r-9-/
Sufficient notification received:Special Conditions yes No
APPROVED:, 9
e
Inspector Date