HomeMy WebLinkAboutDrain Layers Permit 42 Jonanthan Lane ISuD
TOWN OF SOUTH W1NDSOR
DEPARTMENT OF PUBLIC WORKS J '
BUREAU OF POL1Xf ION CONTROL - _«
DRAIN LAYER'S PERMIT 5702
, 199d
k.
Pursuant to written application, ,permission is hereby granted to the
Licensed Drain Layer named. herein to perform the work indicated below at
j r �rvc r+ WS /l�vsc^ 4oZ at premises owned by O K' ( n f-
whose address is #ICP e,_ vv, and to
Lay House Drain, Repair House Drain, Lay Main, Other . ,
for 1sr`'� ,"l occupancy or use, with
Family Urlits , with acres.
Type of Sewage to be connected under this permit : SANITARY SEWAGE
INDUSTRIAL WASTES ( ) , OR
Connection will be made with 6 " Pyc.
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS-
Desired Starting Date p :p2o�. �� Estimated Time for Completion i a
Permit to be issued to A 6t,
n
the holder of Drain Layer's License No. ;c;g4/,6 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 N and/or
CHD Permit No.
Signed
'Licen d Drain Layer
The above named Drain Layer has a valid icense issued bythe State of
Connecticut and has filed a satisfactory bon and insurance policy in the
name of the Town of South Windsor:
Engineering Dept. Date
Permit Fee Paid $ 7%5 Check Number !�j 3 Al
Connection Charge Receipt No. Dated
Issued by d /J
INSPECTION
Date work started Date completed ^ ZZ - 2 Z
Sufficient notific-'ion recei-vea; _ es No
Special Conditions
ns ector Date
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