HomeMy WebLinkAboutDrain Layers Permit 779 John Fitch Boule (2) 7OTO F -SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT �+
5 25� ^`
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19 j
Pursuant to written application, permission is hereby granted, to ,the L'c nsed Drain Layer
named herein to perform t e work. ,in�icated below at '/'/
at premises owned by
whose address is
Lay House Drain, Repair House Drain, La Main and to
for acres. us y ___ Other
Family Units, with occupancy or e, with
Type of Sewage to be connected under this permit: SANITARY SEWAGE
WASTES ( ), OR ( ) (7, INDUSTRIAL
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
J �
V
SPECIAL CONDITIONS
Desired Starting Date 1- q, Estimated Time for Completion
Permit to be issued to pG C D V'tvSwly
the holder of Drain Layer's License No. 0 Ljc v Permit will expire thirty
after date of issuance. The undersigned Drain Layer hereby agrees to all the terms ands
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No. and/or CHD Permit No.
Signed
I Licq d Drain Layer
The above named Drain Layer has a valid license issued by the State of Connecticut and
Ihas filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
1 Engineering Department Date
)nnection Charge Paid
Permit Fee: Paid
Check Number P " ti A-
tt. Issued by
Tax Office
�C,l ION
work started / 9 Date completed "-----/,/ �' g
cient notification received: Yes No
�1 Conditions
APPROVED:
Ins pecto pate