HomeMy WebLinkAboutDrain Layers Permit 71 McGrath Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYERS PERMIT 4 e
Pursuant to written application, permission is hereby granted to the zicensed Drain Layer
named herein to perform the work indi ted below at
�1r,
at premises owned by % J /1'� , )ram _ + l r �� whose address is
and to
Lay House Drain, Repair House Drain, Lay Main, Other ,
for occupancy or usY. INDUSTRIAL
h
Family Units, with / acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (
WASTES ( ), OR ( ) h �' 110 tl Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
r
Desired Starting Date Estimated Time for Completion -- (7
Permit to be issued to .0 iJ��� { n c�514
the holder of Drain Layer's License No. 4,;) ,, :2 -) 1 Permit will expire thirty
y (30) days
after date of issuance. The undersigned Drain Layer hereby agrees �o all the/to s and
conditions set forth in the permit and the reverse side thereof. i t , as eceived
Town Permit No. and/or CHD Permit No.
Signed Ih
Licen ed ra ajer
The above named Drain Layer has a valid license issued by the State o Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
77
Engineering Department Date
Connection Charge Paid Permit Fee: Paid $ �/� /10�
Check Number
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date