HomeMy WebLinkAboutDrain Layers Permit 202 Lisa Drive TOWN OF SOU 'H WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT o, 4260
19 0,
application, J
Pursuant to written a
PP , permission is ereby �rante to the icensed Drain La er
named herein to. perform,,the wok indicated below .4t + f y
at premises owned by 'l
-- whose address is
Lay House Drain, Repair. House Drain, La Main and to
for y , Other
Family Units, with acres occupancy Or use, with
. ,
}
Type of Sewage to be connected
WASTES , OR ( ) INDUSTRIAL
Conn tion 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 yJ Lm,.j S
the holder of Drain Layer's License No. 2 0 fr Z q�, permit will expire thirty after date of issuance. The undersigned Drain Layer hereby agrees to all the terms ands
conditions set forth in the permit and the reverse side thereof. A icant has rece' d
Town Permit No. and/or CHD Permit No.
Signed
i sed 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 ' the name of the of South Windsor:
7
ff Engineering Depa ent Date
Connection Charge Paid�tj"�y Permit Fee: Paid $
l! r f J
Check Number
Al `%�(it t :�.i+1 :J U_'--�ssued by
f Tax Office
INSPECTION
Date work started Date compli-t-ad
SuffiCietrit n6tificatlon received: Yes No
Special Conditions
APPROVED:
Inspector Date