HomeMy WebLinkAboutDrain Layers Permit 41 Jonathan Lane TOWN OF SOUTH Wi N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
'!' ' I I JOnao&n L 1x-, DRAIN LAYER'S PERMIT
1951/
Pursuant to written application, permission is herebyy granted to the Licensed Drain Layer
named herein to perform the work }zdicated below at p � ( ' �f�^��.�r i a�, 4 eJ
at premises owned by —1; -rm S whose address is
and to
Lay House Drain, Repair House Drain, Lay Main, Other
for Y,r -, r ( occupancy or use, with
Family Units, w•th I acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (1-); INDUSTRIAL
WASTES { ), OR ( ) - Connection will be made with
P VC
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date , -1 p 16 -.a4 91 Estimated Time for Completion r C
Permit to be issued to L l h h
the holder of Drain Layer's License No<c Le4/,�, ermit will expire th rty (30) days
y
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 t$ eof. App icant has received
Town Permit No. and/or CHD Permit No.
j
1
Signed
j Lice d Drain Layer
The above named brain Layer has a valid license issue by the State of Connecticut and
has filed a satisfactory bond and insurance policy n a ,name of t e Town of South Windsor:
En inee i Department Date
Connection Charge Paid ` �� b l z S
�Z Perm- t Fee: Paid $
Ch k Ntber
Issued byr
Tax Office
INSPECTION
Date work started ®- 2- 2--91 Date completed ' - 2. 2- 9' 1
Sufficient notification received: Yes No
Special Conditions
APPROVED• -
Inspector Date