HomeMy WebLinkAboutDrain Layers Permit 50 Henry Road (2) TOWN OF SO tH WI N DSOR
DEPARTMENT 0 ' PUBLIC WORKS
b. BUREAU OF POLLS ION CONTROL
y DRAIN LAYER'$ PERMIT o• 4 • "l
r 19
Pursuant to written application, permissi n- is herebyranted to:.the Licensed Drain Layer
named herein to perfoR the work indicated. p'l a t �;
at premises owned by J�?_�" Vt f 1 5 -�0 whose address is
and to
Lay House, Drain, R pair House ;Drai -� Lay Main, Other ,
for occupancy or use, with
Family Units, with acres. s: -
Type of Sewage to be connected under, this e' it: SANITARY SEWAGE INDUSTRIAL
WASTES ( )., OR ( ) Connection will be made with
Show sketch of proposed work or furnish'trao2)F}co es of separate drawings. -
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
c �
Permit to be issued to
the holder of Drain Layer's License No. Permit wih-3-e re-thirty-(3-U}-days
after date of issuance. The undersigned Drain layer hereby ag easy a._-_all the' terms- and
condition's set forth in the permit and the reverse' side thereof. Applicant has received
Town Permit No. and/or CHD Perm it:
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 "poky in he name of the Town of South Windsor:
Z/X
Engineering Department Date
Connection Charge Paid � ! �-{ � � Permit Fee: Paid' $
Check Number
Tax office
INSPECTION
- _ Date work stated- — } ..X ,' �. ;�" . �,��ate-completezl—
--
Sufficient notification ece No -'
Special Conditions
°' Inspector pate