HomeMy WebLinkAboutDrain Layers Permit 965 Main Street (2) DEPARTMENT OF PUBLIC WORKS
( BUREAU OF' POLLUTION CONTROL
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19 c�
Pursuant to written application., permission is her ran ed to the L' ensed Drain Layer'
named herein to perform t, iwor�C. ind�c d below at ,
___�
at premises owned .�y whose address is
and to
Lay House Drain,-: Repair. House Drtiai-n, Ley Maim, ' •Other. ,
for occupancy or use; with
Family Units, with acres.
Type of Sewage to be connected under this permit`: SANITARY SEinACE INDUSTRIAL
WASTES . ( ), OR (, ) ; . Connection will be made with
Show sketch of pr6&sed•work or furnish two (2)• copies of separate drawings.Aar Apo"M
G 01PT
--tea IV
¢: SPECIAL•nc 0 .$, , =" .
Desired Starting Date . Estimat me or Completi0
i, .
Permit to he issued' toCj
r; the ;hgld�t of Drain Layer's =Lie'ense No a in s ..:rails expire• t " (30) days
after dale o issuance: THe uiiiars3gne7 `, rarer ereby agrees y n1 i` rertus and
conditions set forth in the petmit .aru the reverse si . thereof: p e t as .r ceived
`Town Eermt Ntt. nc�lof _ Perm jNo
$igned -
+ io',ne Ya ayer
The above named Drain Layer, :has a valid 1°icense Iss edEby th ate of onnecticut and.
has filed a satisfactory bgi�[d arld insurance pb' 3cy ' ph n o he T of South' Windsor:
Ei inee a .'ePart: iiti Date
'' Connection —tge Paid . (f rpermit .Fee: Baid. -
Check NumbQ 5.
_. Y_ .IssueLLYlsy -- _
57
j
�TNSpECTION ;T
_ __ - T_.- — -- — -
e comp etc
Sufficient notification rec� irre Yes - No '
Special Conndit oils
wsl
Inspector . Date