HomeMy WebLinkAboutDrain Layers Permit 23 Krawski Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT �
' 194
Pursuant to written application, permission is here y�ra d to t1 Li ensed Drain Layer
named herein to.;perform
t e work indicated below at
at premises ovned•by V
whose-•:address is
Lay House Drain and to .
for ' Repair House Drain; Lay Maim T Other ,
Famil Units with occupancy or'use; with` °
y acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ), INDUSTRIAL
Connection will. be made :with
Show sketch of proposed. work` or furnish two (2) copies `of, separate drawings.
SPECIAL CONDITIONS �yf
Desired Starting Date
Esti ted Time for-Completion :
Permit_ to •be is_ sued to
the holder of b'rai# Layer's License'No: 'Peftit will xp lief thirt (30)' da s
after date of issuance. The undersigned Dra'— in'Layer hereby y
Y y ,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
Licensed Drain-Layer
The above named. Drain Lay ' has a valid license issued by the $tate �o Connecticut and
has filed a satisfactory bond. ansi insurance policy in,the awe of`:th'e down of lout Windsor:
ngineering Depar5lment Date
Connection Charge Paid3'1y 64 --;t4'36;�_q Permit Fee:'�Paid-
sl�o bd
Check Number J U
- Issued by -
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification re_oeived: --------- -yes------- No ------ _ —�------ -- — ------
Special Conditions
APPROVED: - ---- - -
Inspector pate