HomeMy WebLinkAboutDrain Layers Permit 45, 47, 49, 51, 53, �` �.i- :•r ,yt:i "h!'R;$'�3"Ri. _ -
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL r�
DRAIN LAYER'S PERMIT NNO, 4 9 /r� i
19 V
Pursuant to written application, permission is hereby ranted to t�� sedicen Drain Layer
named herein to perform the work d' aged belo at r.,w- ,�
at premises owned by �� v. 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
Show sketch of proposed work or furnish two (2) copies o separate drawings.
. 5 ny3 55
57
qcj
qa 53
SPECIAL CONDITIONS
Desired Starting Date -o aT Estimated Time for Completion
Permit to be issued to j * }- ` �}' �� ��F;jP �� riJC.
the holder of Drain Layer's License No. ' 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 s*d� thereof. Applicant has received
Town Permit No. and/or CHD Permit No.
Signed _ iif
jj Licensed Drain Layer
i
The above named Drain Layer has a valid license issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
Engine ing epartment Date
Connection Charge Paid tl Permit Fee: Paid $
Check Number
Issued by
Tax Office
INSPECTION
- -- ate wor_ started - - Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date