HomeMy WebLinkAboutDrain Layers Permit 53 Gorski Drive (2) 1::
TOWN OF SOU
DEPARTMENT OF PUBLIC WORKS ,
BUREAU OF POLLUTION CONTROL No.
DRAIN LAYER'S PERMIT 19X
L
b ranted to the Licensed Drain Layer
permission is hereby g
it'��application, P whose address is
Pursuant towritten
the work indicated below at v ;
herein to perform „j,_�� ! Other
named `=.
at premises owned by Lay Main, �th
Repair Ho use Drain, �— occupancy or use,
Lay House Drain, �--
for acres. A0E ( ), INDUSTRIAL
with
Family Units, wi �-- SANITARY SEW ma
de with
it:
e to be connected under Connection
this perm will be
Type of Sewage
WASTES O, OR ( )
proposed work or furnish two
sketch of Prop (2) copies of sep
arate drawings•
Show
l
�. AL CONDITIONS Completion
SPECIAL Estimated Time or
Date. 30) days
Desired Starting expire
thirty
Permit will all the terms and
to be issued to jr +� ' tees to
Permit License No -- —• hereby ag Applicant has received
of Drain Layer'
undersigned Drain Layer
the holder issuance.
i date of ermit and the reverse side there.o
{ after forth in the p Permit No•
conditions set and/or CHD
Town Permit No- Drain Layer
Signed Licensed
the State of Connecticut
Windsor:
er has a valid license issued by the Town of S
oliciri' the name
of
The above named Drain Lay
bond and insurance p r `F - �
has filed a satisfactory Date
`Engineering Department
, t
Permit Fee: Paid $
Paid Check Number
Charge
`��' � t{
Connection - _
Issued by
Tax 4f f ice
Date completed
INSP� No
work started
- es
Date
Sufficient notification received: A
atE
Special Conditions APPROVED:
Inspector