HomeMy WebLinkAboutDrain Layers Permit 57, 59 Loon Place ;:.+j.;.. ;:E;. ,.�,, ,., .±r., 3 ram. i :a}w..,`k.RE •".'q- '!`R'3n�xa+;. �as�-,-Fi .
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL pp
DRAIN LAYER'S PERMIT M10. 4 9 8 3
Z/0 , 19 �5
Pursuant to written application, permission is hereby granted to the License�d Drain Layer
named herein to perform the wore 'cated bel w at 5-
at premises owned by 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 propose work or furnish two (2) copies of sepa ate drnw;naR_
SPECIAL CONDITIONS
Desired Starting Date 1Z-p_ Estimated Time for Completion }�1t�tJ1 �kS
Permit to be issued to (y} IL42 �jtSS� ��, kic
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 side thereof. Applicant has received
Town Permit No. and/or CHD Permit No.
Signed
Licensed rain Layer
The above named Drain Layer has a valid likens issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
Engineerfilng Department Date
Connection Charge Paid �' G Permit Fee: Paid $ / ,S
— 1
Check Number �-
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special__conditions
APPROVED:
Inspector pate