HomeMy WebLinkAboutDrain Layers Permit 40 McGrath Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 1 �. 4 4 1 6
Pursuant to written application, permission is hereby granted' to the/Licensed Drain Layer
named herein to perfo7)th� work indicated Pelow.at
at premises owned by
� i whose address is
Drain and to
Lay House , 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 O, OR ( )
Connection will be made with
Show sketch of proposed work or €finish two (2) copies of separate drawings.
� � L.RtE/?f7c; i�Fo•
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to lskafl eCO_. . ��; .51 'tJCr7�� (,D.
the holder of Drain Layer's License No. r -_� Permit will ex ire thirty y (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. Applicanhas—received
Town Permit No. and/or CHD Permit No.
Signedr'
icense pMain 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 i� the naame of the Town of South Windsor:
e• i
ngineerir,g De" tment Date
Connection Charge Paid °��L% %?C' Permit Fee: Paid }
Check Number ;!
m=I-C-, Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector pate