HomeMy WebLinkAboutDrain Layers Permit 4 Kellogg Circle j
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION 'CONTROL
DRAIN LAYER'S PERMIT xw No 5854
Pursuant to writan application., permission is hereby granted to the
Licen ed. Drain. Layer named hero n to perform the work indicated belo at
!1�' at p. emises owned by .3f'1'I:T� S
whose address i :4. s'by �/ i)4 Teo a Go
Lay House Drain, Rep.a' House Drain, , Lay Main, Other . ,
f.or occupancy 'or, uses, with .s it
Family Units, w1th acres.
Type of Sewage to be connected under this permit : SANITARY SEWAGE '( ,
INDU'S`TRIAL WASTES'()_ OR
Connection will be made raith
Show sketch ' of proposed work or furnish two, (2) copies of separate drawings.
- SPECIAL CONDITIONS js' ) e_CS 0: lt�
Desired Starting Date 0-`l =fz= -Es. imated Time -for.,Completion
Permit to be `issued to ��:
the holder of Drain Layer.'-s _Li c: nse o 87 Permit will- ex ire thirt
p y
(30) days after date of issuance.' The undersigned Drain LayerL hereby agrees
to all the terms and conditions set forth in the permit and -there,verse side
thereof. Applicant has received Town Permit No . . and/or L.
CHD Permit No..
Signed a�
L cen Dr n Layer
The above named Drain Layer has a. val d license is"s d by the State bf
Connecticut aril has filed a satisfactory bond and '.insurance policy in the
name of the Town of South Windsor:
15-
Elgin eying Dept.. Date
Permit Fee Paid $• .00 Check Number, ��o�
�` +, �
Connection Charge Receipt No. Dated y•-15`22
Issued by
INSPECTION
Date work started b ' ?! ' � / Date completed
Sufficient notification receive:a:LV"Yes No
Special Conditions
-P 7-
- - - - --- APPROVED
Inspector Date