HomeMy WebLinkAboutDrain Layers Permit 199 Lisa Drive TOWN OFF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT NNOv. 4 5 9 7
9� k isa7kve, 3 2— , 19 7
Pursuant to written application, permission is her granted` W the Licensed Drain Layer
named herein to perform the—work indicated elow at 8 l A : %��
at premises owned by
whose address is
Lay House Drain, Repair House Drain, and to
for Lay Main, Other
Family Units, with acres occupancy or use, with
.
Type; of Sewage to be connected
WASTES , OR ) , INDUSTRIAL
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No. .i�? l,S Permit will expire thirt
after date of issuance. The undersigned Drain Layer hereby agrees to all the termsand
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:
3En eee—ring Department Date
7
Connection C age Paid S� .3 /Z Permit Fee: Paid $
Check Number-, 5"7,
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient on rece ve : Yes No r
Special Conditions
APPROVED:
Inspector Date