HomeMy WebLinkAboutDrain Layers Permit 110 Foster Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 4
E ►r!_
19
Pursuant to written application, permission is hereby granted Ao the Licensed Drain Layer
named herein to per£ rm the wo indicated below .at
at premises- owned- by �
_ whose:address 'is
Lay House Drain,.. ,. and to`
for -+— Repair House Drain; Lay Main, Other ,
Family Units, with occupancy o`,r'u�se; witty
acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ), INDUSTRIAL
WASTES ( ), OR--( Connection will• be.made :with
71
Show sketch of proposed work or furnish two . (2) copie's of separate 'drawings:
SPECIAL CONDITIONS - ^
Desired Starting Date �. Estimated. Time for Completion
Permit_ to be' issued :to , . •,.- . - .. .. .
the holder of DraioLarer's License No: Perin t ail ex ire `thin
after date of issuance - ' The undersigned Drain Layer 'hereby
Y (3U) 'days
y y :agrees',,to all the terni��,`and
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit Na, andjor, Ck�D Permit No.
:x Signed
`:' 'hidensed Drain-;Layer
The above named,braiii Layer has a valid. License issued by the 'State;ref Con�iact' cut and
has filed a satisaG.tory bond and itsuranc.e,policy in..the name of the Town of. South Windsor:
Engineering -Department. ,;Date
=--Canne0t_ion.- Charge- Paid' Ax-
, -
Check Number _
(677
_Issued,by, -
Tax 6ffice
INSPECTION
Date- work_started
Sufficient notification received: Yes No
Special Conditions
.APPROVED:
Inspector pate