HomeMy WebLinkAboutDrain Layers Permit 69 Osprey Circle TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT15 59{
19
Pursuant to written applicatio , pelwission is hereby granted o the Licen ed Drain Layer
named herein to perform a k indicated below at �� ,�EG(jj
at premises owned by ,�f5x .work/�E� whose address is
/; «7f/(TC1N and to /t
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 O, OR ( ) 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 / 717
Permit to be issued to •1c ,
the holder of Drain Layer's License No. Z677419 . 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 the permit and the reverse side hereof. Applicant has received
Town Permit No. and/or CHD Permit No. --
Signed,--{ 9
Licensed Drain Layer
The above named Drain La
yer has a valid license iss ed by the Stay of Connecticut and
has filed a satisfactory bond and insurance policy ' th name of t own of South Windsor:
)Enineer• Ve partment Date
Connection Charge Paid�<. j S de Fee: Paid $ �
Ch k umber
Issued by -
Tax Office
INSPECTION
-Date-work-started F Date completed
efficient notification received: es No
ecial Conditions
APPROVED:
nspec or Date
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