HomeMy WebLinkAboutDrain Layers Permit 89 Osprey Circle TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL c
727
DRAIN LAYER'S PERMIT `N0 `�
199Z
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
Eav 2�:� l/ at premises owned by JZa,�,
whose address is and to
Lay House Drain, Repair House Drain, 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 ( ) ' '.
Connection will be made with f/ E
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date -3-9F- Estimated 2Sr
me for Completion 6-��
Permit to be issued to d. it/C
the holder of Drain Layer 's License No. Z077 _., 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 t e permi and the reverse side
thereof. Applicant h s received Town Permit and/or
CHD Permit No.
Signed
censed Dra n Layer
The above named Drain Layer has a v license issued by the State of
Connecticut and has filed a satisfactory nd and insurance policy' in the
name of the Town of South Windsor:
A - t//U ,7 z
n ine g Dept. Date
Permit Fee Paid $ Z5,U(a Chec mber
Connection Charge Receipt No. Dated -P
Issued by
INSPECTION
Date work started ��DDaate completed
Sufficient notif icatio�i —recelvea:
Special Conditions
01
- APPROVED: Z
Inspector Date
11 � / - / i/ � � •
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