HomeMy WebLinkAboutDrain Layers Permit Birchbriar Estates - TOWN OF SOUTH WINDSOR ✓o"� '�� - ��R e 57ao
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 2 `
7 • /p 19�1
Pursuant to written application, permission is hereby ranted to the Licensed Drain Layer
named herein to perform the work indicated below at L�rC, a %;�a �r;
at premises owned by c n f ,SG c whose address is
and to
Lay House Drain, Repair House Drain, Lay Main, l ris Other ,
for I Lc 17T ,•is,(-;r\ occupancy or ur se,with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (X), INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
(,(<, 4�c'; 4'%�<d,� C{ _5;J '�'C S Ch f �:, w I �� 0 -
SPECIAL CONDITIONS
Desired Starting Date 7- 97 Estimated Time for Completion aj>1^'� o<
Permit to be issued to �G��,,_ �irv���P, �r j,'I
the holder of Drain Layer's License No. o2L6416 )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. /
Signed
Li used Drain Layer
The above named Drain Layer has a valid license isstOd by the Sttate of Connecticut and
has filed a satisfactory bond and insurance policy i4 the name of t�6�r&n of South Windsor:
/Engi eering ,e$artment Date
Connection Charge Paid Permit-'Fee: Paid $ S•G O
Check ;Number ? ;9
Issued by !� ..r. .may
Tax Office
r
INSPECTION
Date work—started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED. 2-
Inspector Date