HomeMy WebLinkAboutDrain Layers Permit 469 Graham Road (2) TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT5 4 2r;
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform the work indicated below at o j �n�f h X7 ,'W
at premises owned by f (' v v /V whose address is
rA a 01 iCCIS r and to
Lay House Drain,. Repair House Drain, Lay Main, Other ,
for occupancy or use, with
Family Units, with cj acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE QC), INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
h
Show sketch of proposed work or f�rnski.. two (2) copies of separate drawings.
SPECIAL CONDITIONS wet
Desired Starting Date U - Estimated Time for Completion ai
Permit to be issued to ISCIA" cc"a
the holder of Drain Layer's License No. ( ,�c 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
The above named Drain Layer has a valid licensenissued by the State of Connecticut and
has filed a satisfactory bond and insurance policy ib: th! name of a Town of South Windsor:
—g veer* ;jepartment Date
onnec ion Charge-Paid Permit' Fee: Paid $ /S
i�hec Number
Issued by
Tax Office
4 i
INSPECTION r
- - - rtg-d — Date completed i
OLZU
Sufficient notification received: /� Yes No �-
Special Conditions — `
4 lip
APPROVE r
Inspector Ifatb