HomeMy WebLinkAboutDrain Layers Permit 30 Krawski Drive 'TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT N2 5295
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Pursuant to written application, permission is hereby gr ed to the Li ensed ain ayer
named herein to perform the work ind' ated elow at-
at premises owned by ,e o '
whose address is
Lay House Drain, Repair House Drain, and to
for Lay Main, Other
Family Units, with acres. occupancy or use, with
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( INDU
STRIAL
WASTES C OR
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
GA�A�t
70
SPECIAL CONDITIONS ,5 OFF c utea
Desired Starting Date 6_ a _-e9 Estimated Time for Completion
Permit to be issued to Jnuwj ,4 LIHt3F✓�rFn 1n►c
the holder of Drain Layer's License No. 2q, yi6 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 P�-
- L a sed Drain Layer
The above named Drain Layer has a valid license is?name
a State of Connecticut and
has filed a satisfactory bond and insurance policy in t of the Town of South Windsor:
Engineering Department ate
Connection Charge Paid _ ��
Permit Fee: Paid $
Check Number
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: es No --'�----
Special Conditions
APPROVED: _
Inspect pate