HomeMy WebLinkAboutDrain Layers Permit 55 Loon Place ---rw' ...;..b.. .., .,::..,r ;.,.,:--:c :,-u�a.-- •,x.�:r:, .e+.F.-gin _
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
RAIN LAYER'S PERMIT NNOv 4982
, 19�7
Pursuant to written application, permission is here y granted_ to the Licpnsed Diain Layer
named herein to perform the work d ated be w at
at premises owned by -ate/` 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 of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date 1Z-01- 8Q Estimated Time for Completion
Permit to be issued to 4 5UiTZIL C..¢ ms—k
the holder of Drain Layer's License No. Z61-7 y 9 Permit will expire thirty (30) days
after date of issuance. The undersigned Drain Layer hereb agrees to all the terms and
conditions set forth in the permit and the reverse side eof. Applicant has received
Town Permit No. and/or CHD Permit No.
Signed
A
Livens d rain Layer
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:
/2-�
Engine ling Department Date
r /
Connection Charge Paid Permit Fee: Paid $
Check Number
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions,
APPROVED:
Inspector Date