HomeMy WebLinkAboutDrain Layers Permit 166 Greenwood Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
!_
Pursuant to�writte� cGl)dOd permission P is hereby granted to the Licensed Drain Layer
named herein to perform the work indicated below at G-0 ;
at premises owned by . �.�G fyl` i Z
(rr 2
O /-� whose address is
u�.o r G T.
La House Drain and to
y Repair House Drain, Lay Main, ci Other
for ,
Family Units, with acres. occupancy or use, with
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 t1wo_(2) copies f separate drawings.
r
SPECIAL CONDITIONS
Desired Starting Date 5 Estimated Time for Completion 2"-
Permit to be issued to zrl- I-C,rs i. CD. -i N
the holder of Drain Layer's License No. .2c) EZ93Permit 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
tensed Drain Lay
The above named Drain Layer has a valid lic se .ssued by the State of Connecticut and
has filed a satisfactory bond and insurance poli� ini he name a Town of South Windsor:
ginee i epartment Date
Connection- Charge-Paid- '���-- - it—Fe aid -- �? ----- -- ---- - -
-,Perm P --$ f.)
I i ( Ch�ck umber
Issued by
Tax Office
INSPECTION
Date work _started---- -- --Date-completed- - -- -- -- -
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector pate