HomeMy WebLinkAboutDrain Layers Permit 58 Kingfisher Circle .:. i-r'�,rrE f - -•S�
47
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
D IN LAYER'S PERMIT NNv. 4995
19 c�
Pursuant to written application, permission is here y granted to the Licensed ai -Layer
named herein to perform the work icated below at
at premises owned by r �.�,', whos ,o 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 Z-O\-431 Estimated Time for Completion YGLOAiI'N S
Permit to be issued to J ` I� 5L-w-zi'L_ aNsr_ Ce3. , WC.
the holder of Drain Layer's License No. 20-7-7`I 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' thereof. Applicant has rec 1ved
Town Permit No. and/or CHD Permit No.
Signed
% 1 Licensed Drain Laye
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:
Department Z
Ena r W f
G g g p nt Date
Connection Charge Paid Permit Fee: Paid $
Check NumberA
� eyz Lssued by
Tax F3f f ice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
_-special Conditions
APPROVED:
Inspector Date