HomeMy WebLinkAboutDrain Layers Permit Lot 27 Krawski Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT N2 5294
6 19rf
Pursuant to written application, permission is hereby ranted to a Licens d Dr 'n Layer
named herein to perform the work Indic ted b low t 02 7
at premises owned by ����� �
whose address is
Lay House Drain, Repair House Drain, and to
for Lay Main, Other
Famil Units with occupancy or use, with
y � acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE
WARTRS OR
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate draw"ngs.
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GAkAG
83�
SPECIAL CONDITIONS 6-80 ' DohlN, 1740" —�vP OF WALL- To'
Desired Starting Date _,g_ &> Estimated Time for Completion
Permit to be issued to �J A L,Ha E�eG�z lr l�
the holder of Drain Layer's License No. g0,5416 Permit will expire thirt
after date of issuance. The undersigned Drain Layer hereby agrees to all the termsands
conditions set forth in the permit and the reverse sid ereof. Applicant has received
Town Permit No. and/or CHD Permit No.
Signed
Lic sed Drain Layer
The above named Drain Layer has a valid license i ed by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
Engineering Department ate
Connection Charge Paid Permit Fee: Paid $ X5i6�?
* 3 7/ =-
Chec Number
Issued by
Tax 6f ice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector ate