HomeMy WebLinkAboutDrain Layers Permit 15 Morgan Farms Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 5163
Pursuant to written application, permission is hereby nted to the Lic�ensed Drai Layer
named herein to. perform the work indicated below t
at premises owned by Sl'' - �� C whose address is
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 (3�f, INDUSTRIAL
WASTES ( ), 4R ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date 8- E38 Estimated Time for Completion
Permit to be issued to J* H 5<.qfE,(,.. Co. 10c,
the holder of Drain Layer's License No. 2 07 7Gf 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 he name of the Town of South Windsor:
3 a
Engineering Department Date
Connection Charge Paid , ,�0� -�" Permit Fee: Paid
,/Q,„1 Check Number
r
Issued by ��
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No �—
Special Conditions
APPROVED•
InsWector Date
R