HomeMy WebLinkAboutDrain Layers Permit 99 Greenwood Drive 15, o TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT .
54V
qq J"Lo ooc( D r - 19
Pursuant to written application, permission is here y .ranted to the Licens d Drain Layer
named herein to perform the work indicated below at �, � n
4atremises owned by s r�.hW� ]V /
--A I-pv iS S whose address is
Oand to
House Drain, Repair House D in, Lay Main,
for Other
Family Units, with acres. .'occupancy or use, with
Type of Sewage to be connected under this permit: SANITARY SEWAGE (V), INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies oY f separate drawings.
SPECIAL CONDITIONS {���'q, C,Vr ---
Desired Starting Date Estimated Time for Completion
Permit to be issued to �OV V- E',(� �-- 5�--�,ti.,� �jt^i(.�y-�
the holder of Drain Layer's License No, Permit will expire thirty (30) jays
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"GHD Permit No.
Signed ! lh�`- -�j.
Licensed Drain Laye
T, &"above named Drain,'Layer h s a valid license issued by the State of Connecticut and
has flled'`a sat "sfactory bond aninsurance policy in the name of the Town of South Windsor:
""�""` ^�..yam •, � i�� /�' �� T 50
Engineering Department Date
fr 00
"`'Gannection rge. a Q Permit Fee: Paid $
Check Number
2
� - a Issued by i 9a
Tax Q£f i
` - - ar
Wstarted ' Date completed
ication--.re reds. y
NO
Specia Conditions
-- -- -- APPROVED:
Inspector
' Date