HomeMy WebLinkAboutDrain Layers Permit 36 Natsisky Farm Dri TOWN OF SOUTH WINDSOR
le DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
�^ DRAIN LAYER'S PERMITjo 4492
19
Pursuant to written application x
named herein to erfo permission ig, bereby granted to the�Licensed I1 ain Layer
P rm the work vindicated below �j �E �� ,_,� ``4� It
at premises owned by f.
whose address is
Lay House Drain and to
Repair House Drain, Lay Main,
for Other
Fainily Units, with acres. occupancy or use, with
Type of Sewage to be connected under this permit: SANITARY SEWAGE
WASTES ( ), OR ( ) ( ), INDUSTRIAL
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date Z.--r Estimated Time for Completion
Permit to be issued to ,
74
the holder of Drain Layer's License No. �«/ ' "
after date of issuance. The undersigned Drain Layer hereby agrees Permit will xtorallhtheyterms ands
conditions set forth in the permit and the reverse side thereof.
Town Permit No. and/or CHD Permit No. Applicant has received
S 4L�L'
' ensed 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 the name of the Town of South Windsor:
Engineering Department Date
Connection Charge Paid rr .`
- � % Permit Fee: Paid $ ' `
j_�
Check Number
Issued by
Tax Office
INSPECTION
Date work started
Sufficient notification received: Date completed
Special Conditions Yes No
APPROVED:
Inspector Date