HomeMy WebLinkAboutDrain Layers Permit 83 Osprey Circle . t
TOWN Of SOUTH W1 N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT + 5730
A 19?z
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer arced herein to perform the work indicated below at
at premises owned by )
whose address is -7aK1 and to
Lay House Drain, Repair House DrIain, 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 h'
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 A,&Ir d ,�✓G
the holder of Drain Layer's License No. 'fd7 Permit will expire thirty
(30) days after date of issuance. The undersigned Drain Layer hereby agrees
to all the terms and conditions set forth the pexmi and the reverse side
thereof . Applicant as received Town Per it o. {J and'
CHD Permit No.
Signed
censed I
kkain Layer
The above named Drain Layer has a id license issued by the State of
Connecticut and has filed a satisfactor b nd and insurance policy in the
name of the Town of South Windsor:
C®/9 Z
give g Dept. Date.
Permit Fee Paid $ �+ �� Check Number (-
Connection Charge Receipt No. hDated
Issued by U/9 Z
INSPECTION
Date work started Date completed s�
Sufficient notification received:• des No
Special Conditions
APPRO - -
nspector Date
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CP
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