HomeMy WebLinkAboutDrain Layers Permit 51 Foster Road t
TOWN OF -SOUTH WINDSOR
DEPARTMENT`OF PUBLIC WORKS
00 BUREAU OF POLLUTION CONTROL
1 -
DRAIN LAYER'S PERMIT `41 14 F
Pursuant to written application, permission is hereby nt_ed to t e Licensed Drain Layer
named herein to perform the fork nd carted below atl ? �
at premises owned by whose address is
mac, -�; ,` ,f�.`� ..>, ee� �:v�>Sc;� J and to
Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use, with
Family Units, with a' 'i� acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (4 " INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with l
S' <, 3
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date 7/2.011b �/ Estimated Time-for Completion
Permit to be issued to X114��1;111<Allll',f `
the holder of Drain Layer's License No. 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 Cl�Kccsv�:.�
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:
-7/Z 0/&c-�
Engineering Department Date
Connection Charge Paid
g Permit fee: -Pair$-- �v) •��
Check Number l�
``, Ck-f:�./it: Issued by
Tax Office
INSPECTION
Date.work_ stated _Date com
Sufficient notificatio re eived: Yes No
Special Conditions
APPROVED:
I spect Da e