HomeMy WebLinkAboutDrain Layers Permit 181 Graham Road �s TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT No. M l
Pursuant to written application, permission is hereby granted
to the icensed Drain Layer
named herein to perform thp work indicat bel at J,-/ G
at premises .owned by whose address is
and to
Lay House Drain, Repair House Drain, Lay Main, Other ,
for 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
Show sketch of proposed work or furnish two (2) copies of separate drawings.
60 41
P
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
�l
Permit to be issued to
the holder of Drain Layer's License No. c Permit will;exp red hirty (30) days
after date of issuance. The undersigns Drain Layer hereby agrg`es o aii the terms and
conditions set forth in the permit and the reverse side the eof. pliFant has received
Town Permit No. and/or CHD Permit No.
Signed ' 4'
c nsodr # Layer
The above named Drain Layer has a valid license iss ed by t e State o /Connecticut and
has filed a satisfactory bond and insurance policy in t me of the T.
of South Windsor:
Engineering Department Date
Connection Charge Paid Permit Fee: Paid $
Check Number 7/V
— -
Issue y
�4Tax Office-
INSPECTION
a-e--wUrr—stalf ted Diffe comp ete
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date
Ir2q rV 1
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