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HomeMy WebLinkAboutDrain Layers Permit 66 Meadow Road TOWN OF SOUTH W!N DSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL p q DRAIN LAYER'S PERMIT k's`N2 5843 19 �2 Pursuant to written application, permission is hereby granted to the Licensed Dray Lay r1named herein to perform the work indicated b ow at h� 4Ylga CL4 Ad. at premises owned by m '` n whose address is 'a .� and to Lay Hou a Drain ; Repair House Drain, ' Lay Main, Other , for 1 - oc.cupancy or 'use, with Family Units, with I acres. Type of Sewage to be connected under this permit SANITARY SEWAGE ) , INDUSTRIAL WASTES ( )', OR Connection will be made with Shoy� sketch of roposed work or furnis two (2) c pies Qf s'e agate drawings. Cam►11 7 0 v fop � 9.,1 3 c/0?6 n SPECIAL CONDITION$ Desired Starting Date G J , Esti ated Time for Completion Permit to be issued to -Jrl� ow1 the holder of Drain Layer's License No. Permit will expire thirty (30) days after ,date of issuance.. The. un,dersigned Dian Layer hereby agrees' to all the te-rms .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 bo d and insurance policy in the name of the Town of South Windsors /9z i ng nee g Dept. Date Permit Fee Paid $ �J^'� Check N ber iq Connection Charge Receipt No. ZZ¢ Dated 9 ,J 1g Z Issued by. A1Jt_?, INSPECTION Date work started 0_ 2• Date completed Sufficient notificaf on, receive . _ es No Special Conditions APPROVED• f©" _ Inspector Date