HomeMy WebLinkAboutDrain Layers Permit 177 Kent Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT 5835
19
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
Irr7Z7t kL-nf LAMP at premises owned by
wh address is and to
Lay House Drain, Repair. House Drain, Lay Main, Other ,
for occupancy or use, with
Family Units, with acre"s.
Type of Sewage to be connected under this permit : SANITARY SEWAGE
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with 1(Yl S
Show sketch of proposed work or furnish two (2) copies of separate drawings.
- SPECIAL CONDITIONS CAP 1qN
Desired Starting Date 1042,2 Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer ' s License No. a .. Permit will expire tktirty
(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 21
Licensed Drain Layer
Th.e above named Drain Layer has a valid license issued by the State of
Connecticut and has filed a satisfactory bond and insurance policy in the
name of the Town of South Windsor:
9 -/0--9
,C0�0�1�C- Engineering Dept. Date
Permit Fee Paid $ ✓� Check Number
Connection Charge Receipt No. A/ w Dated C/ "Z-
- Issued by / w
INSPECTION
Date work started �} �/Q��v Date comgle°ted
Sufficient notif is=ion receives : des No
Special Conditions
_ .
AP.PROVED -
Inspector Date