HomeMy WebLinkAboutDrain Layers Permit 81 McGrath Road 7"mi
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT NO 4102
Pursuant to written application, permission is hereby ,K,an
ted di to e,,Licensed Drain Layer
/
named herein to perform the work inl* t d b low at cj-L,�" I
at premises owned by 4z whose address is
fi and to
Lay House Drain, 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 (V), INDUSTRIAL
WASTES OR Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
ILL
49' cp(^WCAS
AsAwLT
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to k, 4" 1-1r) -r
the holder of Drain Layer's License No. 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. Applicant has received
Town Permit No. and/or CHD Permit No.
Signed
Licensed Drain 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 in the name of the Town of South Windsor:
Engineering Department Date
Connection Char e Paid Permit Fee: Paid $
Check Number l21
Issued by
Tax Office
11
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date