HomeMy WebLinkAboutDrain Layers Permit 60 Hayes Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT dare ''�
w 537f;
ov � 3 19cf
Pursuant to written application, permission is hereb grated' to the ice sed Drain Layer
named herein to perform the fork i dic t:e below at C.F' �- �"
at premises owned by ��� F . e� whose address is
Lay House Drain] Repair Ouse Drain Lay Main, and to
Other
for /` , fl �U r �5 � occupancy or use, with
Family Units, with _ acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (7), INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date b S Estimated Time for Completion
Permit to be issued to AL M IA /Sly I e LtJS Ct i
the holder of Drain Layer's License No. Q y (o, !i! 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.
SignedG�GI/1►i ING�y�r�I
Licensed 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 n th name of t e Town of South Windsor:
Ang'neer epartment Date
Connection Charge Paid' ` (5 Perm i Fee: Paid
Peck Number
Jj
Issued by
Tax Office
INSPECTION
Date work started 9 Date completed 6
Sufficient notification rec ve ,: es No
Special Conditions
APPROVED: 42,
nspector e