HomeMy WebLinkAboutDrain Layers Permit 84 Sandpiper Place ,Y;'.v �- €tcc-a�fz��., i�E�i�`?F�V_ a.p�,.1��9�.,. .. �. ' ] .._. , -
t TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
V BUREAU OF POLLUTION CONTROL
PLI DRAIN LAYER'. PERMIT R'� 1-3 7
19: r,
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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 l��i- IZ L ,jD
at premises owned by whose address is
f U!J ( 0 and to
Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use, with t
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (( , 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 F 1'l U Estimated Time for Completion
Permit to be issued to t� JUG I �- Cya QJ,(. L.v 1)J
the holder of Drain Layer's License No. G 9 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 brain Layer
L/
The above named Drain Layer has a valid license issued by the State of Connecticut and
has filed a satisfactory bond and insurance polio in ^ he name f the Town of South Windsor:
{.
E ginee i Department Date
Connection Charge Paid /- �cj - "� C er 't Fee: Paid $ v
ec Number
I
I
Issued by
Tax Office /
INSPECTION J
-- Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date
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