HomeMy WebLinkAboutDrain Layers Permit 161 Morgan Farms Roa;,.-�.. ._,.:.1:., _,.'�.. " .;,.;.r, 's,Tw�tc: .,<=+Sl.r,9�,:+ x'N"?5i4 Nht/2T""�A7°1s+ 'Slrr3•xR:.;,�ru °'.'_` ,� ". ;;' .. 3'�
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT X0, 4893
19 C�I m or axe �an.rv�o DL• --U-
/
9
Pursuant to written application, permission is h reb &ante to the L , sed Drain Layer
named herein to perf
at premises owned by o the wo k i dicatec� below at b �Jl i` ( �
{' 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 ( ), INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date `- e. Estimated Time for Completion Z GIJCf�S
Permit to be issued to
the holder of Drain Layer's License No. Z6 7 7 V/' Permit will expire thirty (30) days
after date of issuance. The undersigned Drain Lay jr ereby agrees to all the terms and
conditions set forth in the permit and the reverse a thereof. Applicant 1#s received
Town Permit No. and/or CHD Permit No.
Signed
Licensed' ain Laye
r
The above named Drain Layer has a valid lic�'ne issued by the State of Connecticut and
has filed a .satisfactory bond and insurance polity i h name of the Town of South Windsor:
Engineering Department Dane
Connection Charge Paid�`� 7 Permit Fee: Paid $
Check Number
Issued by
Tax Office
INSPECTION p
Date work started Date completed j<J- O 00,?
Sufficient notification received: Yes No !
Special Conditions
APPROVED-
Inspector pate