HomeMy WebLinkAboutDrain Layers Permit 222 Graham Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT N2 5132
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Pursuant to written application, permission is hereby granted t the Licensed Drain Layer
named herein to perform the work indicated below CU2 Z Z
at premises owned by
'' whose address is
Lay House Drain, Repair House Drain, and to
for Lay Main, Other .
Family Units, with occupancy or use, with
acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (WASTES OR ), INDUSTRIAL
( ), ( )
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
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SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No.4 O 6 Permit will ex
after date of issuance. The undersigned-Train Layer hereby agrees torall hthe irtyterms ands
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
The above named Drain Layer has a valid license is ued by the State of Connecticut and
has filed a satisfactory bond and insurance po=Engneering
name f the Town of South Windsor:
Department Date
- -Cdn.nec�on Charge Paid `Z. 2 -tom
Permit Fee: Paid $ r��
Check N er
L �f�/`/ � Issued by j j
Tax Office
INSPECTION
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Sufficient notification received: Date completed
Yes No
Special Conditions
APPROVED:
Inspector Date