HomeMy WebLinkAboutDrain Layers Permit 56 Kingfisher Circle �.
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TOWN , OF SOUTH WINDSOR
DEr�RTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT NNo. 4994
h )j o 19
Pursuant to written application, permission is hereby granted o t i3�nsed D ai Layer
named herein to perform the work in ated below t 55cc�5 --' 6 /�-
at premises owned by whos ddress is
and
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-0k- Estimated Time for Completion 3 Vj(O�jTE{
n
Permit to be issued to J cjLt rZ (!k)r,s-
the holder of Drain Layer's License No. 2-67 7t4q 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 sid ereof. Applicant has rec '
Town Permit No. and/or CHD Permit No.
Signed
Licensed Drain 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 thee name of the Town of South Windsor:
Engineer g Department Date
Connection Charge Paid f' v /i ? 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