HomeMy WebLinkAboutDrain Layers Permit 141 Lisa Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT 4783
July pr. , 19�rf
Pursuant to written application, permission is hereby _rantedato the
named herein to perfo the wo rk i d' ted low at & cens�d Drain Layer
at premises owned by
whose address is
La House Drain and to
3' Repair House Drain, Lay Main, Other
. for ,
Family Units, with acres. occupancy or use, with
Type of Sewage to ho conneGted under this pelm±t; SANITARY SEWOE
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 DNIPFrt G�ckJC-A—) a
the holder of Drain Layer's License No.ZpgZ 9:. 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. A plicant has received
Town Permit No. and/or CHD Permit No.
Signed
censed Drain er
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:
E gineeri g Department Date
Connection Charge Paid - � Permit Fee: Paid $ h b
j` Check Number b
Issued by
Tax offic
INSPECTION
Date work started _ - ij_ f?� _ Date
Sufficient notiticatio received eS No
Special Conditions
APPROVED:
Inspector . Cl Date