HomeMy WebLinkAboutDrain Layers Permit 15 Jared Court ��q v
5� TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
U � BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT *' 'NO 5 5
Pursuant to written app . cation, permission is hereby granted to the
Licensed Drain Layer named he . in t perform the work indicated below at
T a ��premises owned by (j
whose address is O C/" and to
-Lay House Drain, Repair Hous Drain, Lay Main, Other (,EJ "CQ
for occupancy or use, with
Family Units, with 3 acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ) ,
INDUSTRIAL WASTES ( ) OR ( ) ,��� ���o� �
Connection will be made with -7-1 Q 2 *�r,''CE
Show sket h of proposed work or furnish two (2) copies of separate drawings.
P
--SPECIAL CONDITIONS �� La 0 - d dCP1&W&
- -
Desired Starting. Dat 7-3 Estimated Time for Completion
Permit to be issued to �' f� MJ
the holder of Drain Layer 's cense 'No, cg�Ty. 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 . a,ndlor .
CHD Permit No.
Signed
Licen e Zed
ain Layer
The above named Drain Layer has a val licen a4 is by the State of
Connecticut and has filed a satisfacto y and and insurance policy in the
name of the Town of South Windsor :
¢11 �` z
ngiy&ing Dept.... Date
Permit Fee Paid $ 00 Che Number f b `T30
Connection Charge Receipt No. 4-1.S-1 Pated -Z/—
_ Is•sued by
INSPECTION 77
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED.. .
Inspector Date