HomeMy WebLinkAboutDrain Layers Permit 66 Greenwood Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 0 5096
Pursuant to written applicati wood, Or,
on, permission is hereby granted to the Licensed Drain La er'
named herein to perform the work indicated bel9V at , % ' 3'
at premises owned by it _ } 1 ,. �4
Lay House Drain, Repair House Drain, La and to r _„
for y Main, Other
Family Units, with acres. occupancy or use, with
Type of Sewage to be connected under this permit:
WASTES OR SANITARY SEWAGE (01, INDUSTRIAL
( ), ( )
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONSf�eeT
Desired Starting Date S - -- ey,1 Estimated Time for Completion 1- —
Permit to be issued to
the holder of Drain Layer's License No.
Permit will after date of issuance. The undersigned rain Layer hereby greesxtor all hthe yterms
and
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No. and/or CHD Permit No.
Signed
Lice ed Drain Layer
The above named Drain Layer has a valid license issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
En ineering Department Date
Connection Charge Paid —j`('��j. j
Permit -Fee: Pa
Check Number
Issued by
Tax--Office _ :,
INSPECTION
Date work started (�-Suff- ' Date completed
n —noi-ea� on eCeIVUU; A-
Special Conditions - -
--
No
APPROVED•
y� Inc
;pedfW Date