HomeMy WebLinkAboutDrain Layers Permit 198 Natsisky Farm Ro TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
• DRAIN LAYER'S' PERMIT
No. 4943
Pursuant to written application, permission is hereby granted to thg Licensed Drain Layer
named herein to perform
,,,the work indicated below at i1i
at premises owned by � � � " ✓ r .. j, �'-,
! `�, '�IJ whose address is
Lay House Drain, Repair. House Drain, La Main and to
for Y Other
Family Units, with acres. occupancy or use, with
Type of Sewage to be connected under this permit: SANITARY SEWAGE ,
ASTES (�), OR ( ) ( ) INDUSTRIAL
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
6A4 L - ),41P
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. SPECIAL CONDITIONS 7 C C j
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No.
Permit will expire thirty (30j 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 -- -
Drain Layer
The above named Drain Layer has a valid license sued by �the State of Connecticut and
*as filed a satisfactory bond and insurance polic th
y / y Y e/na a o the Town of South Windsor:
Engineering Department Date -r—�
Connection Charge Paid
Permit Fee: Paid $ i
i Check Number
Issued by
Tax O ice
�uvar�t,11VN
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED•
Inspector Da-e