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HomeMy WebLinkAboutDrain Layers Permit 27 Jonathan Lane TOWN OF SOUTH WtNDSOR 9a r..90 84 DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL � . , DRAIN LAYER'S PERMIT `t e 5776 Pursuant to. written application, permission is hereby granted to the Licensed Drain Laye named herein to perform the work indicated -low at I. 04 IU oh AkaLA at premises owned by (� (GAS whose address is M 6i k Q and to Lay House Drain, ✓" Repair House Drain, Lay Main, Other , for occupancy or use, with Family Unit , with acres. Type of: Sewage to be connected under this permit : SANITARY SEWAGE (y', INDUSTRIAL WASTES OR ) Connection will be made with 4 Show sketch of proposed work or furnish two (2) copies of separate drawings. .. G74 SPECIAL CONDITIONS Desired Starting Date j _a.9 -tea Estimated Time for -Completion a Permit to be issued to c'1�il, the holder of Drain Layer's License No. p£��#J6 Permit will expire thirty ('30) , days after date o.f 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 cease Drain' Layer The ,above named Drain Layer has a valid i ense issued by the State of Connecticut and has filed a satisfactory and d in ranee policy. in the name of the Town of South Windsor ©� f'E1kgi'niMqng Dept.. - Date Permit Fee Paid $ , �'� Chec umber Connection Charge Receipt No. */S Dated �-r Z. Issued- by INSPECTION Date work started Date completed Sufficient' notification rece ve : yes No Special Conditions 110, 9. Itlspector Date