HomeMy WebLinkAboutDrain Layers Permit 66 Kingfisher Circle "e,
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT NNO, 4998
19
Pursuant to written application, permission is here y ranted to the C tin Layer
named herein to perform the work yid' ated below a - { .
at premises owned by _r"� r yv� .r-� w e address is
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 JZ -QI- P7 Estimated Time for Completion 3 YY16�T1IS
Permit to be issued to �`� 51_:4—)-Z � , Cb Ayr, `. (4)C,
the holder of Drain Layer's License No. Z O7 7�` . Permit will expire thirty (30) days
y
after date of issuance. The undersigned Drain Layer her agrees to all the terms and
conditions set forth in the permit and the reverse sid th reof. Applicant has received
Town Permit No. and/or CHD Permit No. f�
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 the name of the Town of South Windsor:
Engineering Department Date
Connection Charge Paid Permit Fee: Paid $
�' Check Number 'c �_.
Issued by
Tax Office
i
I INSPECTION
Date wor started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector pate