HomeMy WebLinkAboutDrain Layers Permit 51, 53, 55, 57, 59 L -i'-�::++. `"• `. s,, a�^. -�-.k:o^�r' .;v'r'.'*ntae�:yza: pe} e! i's.- ,ss.. .' - . _
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TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
4980
DRAIN LAYER'S PERMIT
19L
Pursuant to written application, permission is hereb granted to the Licens Drain Layer
named herein to perform the work 'n 'cated belo at �' // -- S% � _�
at premises owned by ��t� c.�-rt-a. 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 proporped work or furnish two (2) copies of separate drawings.
0
3
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion 3 t3'1ol�i IDS
Permit to be issued to (r�
y� the holder of Drain Layer's License No. Zo7-7'41-j Permit wily 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 \ � �` a
Licensed Drain Layer
The above named Drain Layer has a valid licensesissued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
Engin Bring Department Date
Connection Charge Paid . L!2� // /b ` Permit Fee: Paid $ 3
Check Number � Z
Issued by G�
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
-----Special conditions
APPROVED:
Inspector Date