HomeMy WebLinkAboutDrain Layers Permit 172 Morgan Farms Roa TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL ��TT
DRAIN LAYER'S PERMIT NNO, 4805
Pursuant to written application, permission is h reby. grated o the Licensed-Drain Layer
named herein to perform-the wo k indicated below.at 7 <_./ 1.6, , (" t'2 r /"� -! 1r
at premises owned by ,. �' , j,L,., .4 ;' E� _�;, 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 7 3/- 7 Estimated Time for Completion
Permit to be issued to V / ilw y—�
the holder of Drain Layer's License No. Zvi 7-7yy . Permit will expire thirty (30) days
after date of issuance. The undersigned Drain Layer eby agrees to all the terms and
conditions set forth in the permit and the reverse si, a thereof. Applicant s rec ivied
Town Permit No. and/or CHD Permit No. �'
Signed
Licensedf Mrain Layer
The above named Drain Layer has a valid lice issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
Z/Y- 7-Z �-4�,CZ
Engineering bepkrtmpt Date
Connection Charge Paid .�f / Permit Fee: Paid $
Check Number j
Issued by T
Tax Office
INSPECTION
Date work started /�_ ^ 7 Date completed - �� F 7
Sufficient notification received: (---Yes No
Special Conditions
APP
Inspector Date