HomeMy WebLinkAboutDrain Layers Permit 189 Krawski Drive TOWN OF SOUTH W1 N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT , _ 3614
Pursuant to written .application, permission is he b gran tos the Licensed Drain Layer
named herein to. pergforlpAhe work indicated •below at
at premises owned by' whose.:address is
and :to
Lay House Drain, Repair House Dre il' 'Lay Main, Other ,
for � '�'®; - occupancy or `use, with
-
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE , INDUSTRIAL
WASTES ( ), OR ( ) S, Connection will be.made with
}
Show sketch of proposed work or furnish two (2)' copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit- to be issued to
the holder of Drain Layer's �L cense No. Permit will expir think- 00 ays
after date of issuance. The undersigned Drain Layer hereby agrees to all`the to s'and
conditions set forth in the permit and the reverse side thereof. Appiicant` as received
Town Permit No. and/or CHD.Permit No.
Signed
LieensedlDran Layer
The above named Drain Layer has a valid license issued by the State of:`6hii `cticut and
has filed a satisfactory..bond and insurance policy in the name. of the Town of South'Windsor:
7,7�/
Engineering Department Date
Connection Charge Paid '-/UQ'-0 y Permit Fee 'Paid $ 15, 06
Check
Issued bys��
pTax of f e/�'
INSPECTION
_ -- — ------ -- -------— ---- — -- 3--
Date wort started-- -----
- � DateD-- completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date