HomeMy WebLinkAboutDrain Layers Permit 890 Foster Street Ex TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
19`y
Pursuant to written application, permission is hereb ranted to th Licensed Drain Layer
named herein to. perform th work Indicated below at
at premises owned by ",� -- ''% C.` _ `; ✓c.,. �--�—
"l whose address is
and to
Lay Houser Drain, Repair House Drain, La Main
for Y , Other ,
Family Units, with acres. occupancy or use, with
Type of Sewage -to-be connected underthis permit: SANITARY SEWAGE �( INDUSTRIAL
WASTES ,
( )� OR ( ) Connection will be made with
Show sketch of proposed work or furnish t o (2) copies of separate drawings.
._ 1/ q i
SPECIAL CONDITIONS
Desired Starting Date c
��="� ;�.r' Estimated Time for Completion
Permit to be issued to `w
the holder of Drain Layer's License No. fr Permit will expire thirty (30) da s
after date of issuance. The undersigned Drain yer 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 _ -
Licejsedr-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:
__4nDepartmentEnginee Date
Conne nti n-Charge -Paid � ��-- __ ---- -_
I �-� _ --Permit Fee:-Paid $ -��------
Check Number ZLL—G�
�`—
Tax Office Issued by
INSPECTION
Date .work started- ----
Sufficient notification receive -: Yes No
Special Conditions
APPROVED:
ff-
nspector r Date