HomeMy WebLinkAboutDrain Layers Permit 855 John Fitch Boule TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
=-m 545 1
1995 -1
Y0
Pursuant to written application, permission is he '
named herein to perform the work indicated below at .
at premises owned by
granted to the L'c sed Drain Layer
^—
-v whose address is
Lay House Drain, Repair House Drain, and to
for Lay Main, Other
Family Units, with occupancy or use, with
acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (DO, INDUSTRIAL
WASTES ( ) OR ( )
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate dra wings.
T
a c�"....r✓1 rt-��l
SPECIAL .CONDITIONS .�x. is isv ' _".��/;,s.s+.. >?',• ' I--; r
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No. U Permit will expire thirty
after date of issuance. The undersigned Drain Layer hereby agrees to all the terms and
inditions set forth in the permit and the reverse side thereof. Applicant has received
wn Permit No. and/or CHD Permit No.
Signed
Licensed Drain Layer
he above named Drain Layer has a valid license issued by the State of Connecticut and
ed a satisfactory bond and insurance policy in the name .of the Town of South Windsor:
Engineering Department Date
Charge Paid Permit Fee: Paid $ A359
r r�
Check Number
Off ce
Issued by
i
Date completed tion received: es No
APPROVED: ^ 90
Inspector Date