HomeMy WebLinkAboutDrain Layers Permit 713 Foster Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 5929
19 3
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below a
at premises owned by /-�/��a�Z- �Sj•a�' �
whose address is and to
Lay House Dra n, Repair House Drain, Lay Main, Other
for 1-4A I occupancy or use, with --�
Family Units, with acres.
Type of Sewage to be connected under this permit : SANITARY SEWAGE ( ,
INDUSTRIAL WASTES ( ) , OR (
Connection will be made with 15771
Show sketch of proposed work or furnish 'two (2) copies of separate drawings.
P
own
SPECIAL CONDITIONS 4 IREMENTS MUST BE FOLLOWED
Desired Starting Date r EstiTrrj�,k�
d Time for Completion
Permit to be issued to
the holder of Drain Layer's License No. ojo 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 the
name of the Town of South Windsor:
Engineering Dept. Date
Permit Fee Paid $ 2�5-'' Check Number
Connection Charge Receipt No. Dated 1-:-5
b
INSPECTION
Date-work started
Date completed �
Sufficient notifica� .o-n ec.e ve : eyes No --
Special Conditions
Inspector Date