HomeMy WebLinkAboutDrain Layers Permit 22 Linda Lane (2) TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
I��A111 fj BUREAU OF POLLUTION CONTROL
W g ?' DRAIN LAYER'S PERMIT No 5830
19
Pursuant to written application, permission is her by granted to the
Licensed Drain Layer named herein to perform the work indicated below at
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 proposed work or furnish two (2) copies of separate drawings .
;A 1
SPECIAL CONDITIONS i ��<
Desired Starting Date Estimated Time for Completion
Permit to be issued to
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 -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 :
f
,"-Enginee'rj.ng Dept . Date
Permit Fee Paid $ Check Number
f,
Connection Charge Receipt No. ( Dated
Issued by A--
INSPECTION
Date work started Z�1 9 2 Date completed 6 7--9
Sufficient notific—NEio4r receives 'es No
Special Conditions
i
APPROVEg
Inspector Date