HomeMy WebLinkAboutDrain Layers Permit 306 Foster Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT N2 5151
, 19
Pursuant to written application, permission is hereby grante to 4he Licensed Drain Layer
named herein to perform t work indicated ow at (f ��
at premises owned by
whose address is
Lay House Drain, Repair House Drain, and to
for Lay Main, Other ,,
Family Units, with acres. occupancy or use, with
Type of Sewage to be connected under this permit:WASTES OR SANITARY SEWAGE ( ), INDUSTRIAL
( ), ( )
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
pVe
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SPECIAL CONDITIONS 2 f �-- ��� ���� ^00 / Q
Desired Starting Date Estimat d Time for Completion
Permit to be issued toPermit will
the holder of Drain Layer's License No.
after date of issuance. The undersigned Drain Layer hereby agreesxtorallhtheyterms ands
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No. and/or CHD Permit No.
Signed
aa'�.
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 tplrgme of the Town of South Windsor:
77 Engineering Department Date
Connection Charge Paid OZ L Permit Fee: Paid $
Check Number
Issued by
Tax Mi
INSPECTION
Date work started -Date completed - - ► -- -
Sufficient notification received: Yes No
Special Conditions
APPROVED: 4'
Inspector pate