HomeMy WebLinkAboutDrain Layers Permit 78 Sandpiper Place ... .., ... .. :,.. .:f ., 7,w�F ,i'-77-r^ru7m+�rr�a[ ,
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT p 5394
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Pursuant to written application, permission is hereby`granted to the Licensed Drain Layer
named herein to perform the work indicated below at �. C-1 L -.,,_,`J
at premises owned by whose address is
and to
Lay House Drain, v` Repair House Drain, Lay Main, Other ,
for r occupancy or use, with ?
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (14, INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date 1'e t') 1 ! -I,+0 Estimated Time for Completion 11 , ;
Permit to be issued to u ,) H �t 't i .1� +. a%.f
the holder of Drain Layer's License No. `L.:�`77LA -1 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 thereof. Applicant has received
Town Permit No. and/or CHD Permit No.
Signed
/.
Licensed Drain Layer
The above named Drain Layer has a valid licen�� issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy i th��name of tjr Town'of South Windsor:
i eerin$ artment Date
Connection Charge Paid �- '�'� - �'j � Permit Fee• Paid $
`Ch k Number 4-1
Issued by
Tax @ffice
INSPECTION
_ -Date work-started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED: Y
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