HomeMy WebLinkAboutDrain Layers Permit 24 Jared Court TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT ;tNo 5769
- 2 Z 19
Pursuant to written application, permission is hereby granted to the
Li en ed Dra.i Lay r n med erein to perform the work indicated belo at
p Y ef7WitfT at re is s o ned by �S rpy1S
whose address is !?
h D� I S. !� and to
Lay House Drain, Repair Ouse Drain, Lay Main, Other !- --
for occupancy or use, with SI`1 ale-
Family Units , with 3 acres.
Type of Sewage to be connected under this permit : SANITARY SEWAGE ( ) ,
INDUSTRIAL WASTES ( ) , OR ( ) J.
Connection will be made with GS
Show sketch of proposed work or furnish two (2) opies of se arate drawings.
SgEGIAL-GONDI-T IONS_
- ---- -- � -- --- -----
Desired Starting Date Estimated Time for Completion
Permit to be issuW to Sa hn -,Fla G 04APS'
the holder of Drain Layer' s License No. 2,.V5$30 .. 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. Tom,
Signed
.Line sed ain Layer
The above named Drain Layer has a valid license i sued by the State of
Connecticut and has filed a satisfactory b nd anA-
n rance policy in the
name of the Town of South Windsor: .
ZZ �9Z
ine g Dept. Date
Permit Fee Paid $ ^iV� Chec N mber 1e)
Connection Charge Receipt No. ��� Dated -S7za/9
Issued by .S 2
INSPECTION
Date work started - q ..`_ ate completed 7'Z 7- - -
Sufficient notification�r�eive J`�tes 9J-No
Special Conditions
Inspector Date
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