HomeMy WebLinkAboutDrain Layers Permit 29 Krawski Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
t- - 19�
Pursuant to written application, permission is ere y g ant to the Licen ed Drain Layer
named herein to. :perform .t a work- indicated below at,
at premises'owned;'by ,� A `0� kpa whose address is
and t_o•. ..;
Lay House Darin, Repair 'House Drai "'
-- {� Lay' Main, Other ,
for occupancy or'use,. with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE I
ES OR k "..Connection will be made with
Show sketch of proposed work or furnish two (2) copies 'of 'separate drawings. -
SPECIAL CONDITIONS O
esired Starting"Date
Es.tima ed =Timre for-.,Completion. ..
Permit- to -be issued to
the holder of 'Drain Layer'-s I;icense No: r
_�.' Permit w11 ep re thirty { 0) 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"las' received
Town Permit No. >, andor.,CHD Permit No.
Signed:
Licensed .Drain-.Layer
The above named D a Layer hsd v` ,
rs A; _ .y , .411A t,�a.cex}se issued by the State of Corttr�ct cut and
has filed a satisfactory bond and ,insurance policy the name: of the Tgwn'of South;Windsor:
r: 4 8
Engineeri g,Department. Dat,
Connection Charge Pad,3� � '�6 Perriftir,`Fees' Paid r
Check Number (�
Issued By''
Tax 5f f ice 7.Z7
INSPECTION
Date work started Date completed
Suf f dent—no cation-received.----—----Yes --
Special Conditions
- - -- - - _ _ - -APPROVED.- -- _
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Inspector Date