HomeMy WebLinkAboutDrain Layers Permit 37 Kelly Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL C
793
DRAIN LAYER'S PERMIT 0 `�
1992-
Pursuant to written application, permission is hereby granted to the
Licen&NW
D Layer named herein to ,perform the work in�d,,}'cated elow at
� at premises owned by IVIIW14 �=W0S/LLtj
whose address is and to
Lay House Drain, Repair House Drain, Lay Main, Other ,
for occupancy or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit : SANITARY SEWAGE (>4,
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with "(>U C
Show sketch of proposed work or furnish two (2) copies of separa a drawings.
ElittCe
-- - SPECIAL CONDITION'S ! � 6 �rJC-
r
Desired Starting Date J3ra2-3 g( Estimated Time for Completion/
Permit to be issued to -
the holder of Drain Layer ' s License No. 22f06';" 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 l/
L"iceitsed Drain Layer
The above named Drain Layer has a valid license issued by the State of
Connecticut and has filed a satisfactory and and insurance policy in the
name of the Town of South Windsor: All /
z%a�
ngi a ing Dept. Date
Permit Fee Paid $ ZS:OU Check Number 6015W 61k/97-
Connection Charge Receipt No. 1 g Dated &1/e1'9`L
Issued by
INSPECTION
Date work started Date completed
Sufficient notification received: es No
Special Conditions
AP P V - - - - - ----
.. ..�
Inspector Date