HomeMy WebLinkAboutDrain Layers Permit 47 Natsisky Farm Roa TOWN . OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
(� DRAIN LAYER'S PERMIT No. 4599
Pursuant to written applicat on, permission is here,b y granted to the icens d ain ayr
named herein to perform work indicated low�at
at premises owned by
whose address is
Lay House Drain, Repair House Drain, and to
for Lay Main, Other
Family Units, with acres. occupancy or use, with S
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 Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No. 007
after date of issuance. The undersigned Drain Layer hereby agrees xtor all htheyterms and
days
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No. and/or CHD Permit No.
Signed / J
Licensed Drdin 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:
,3 ��=- Date �
ngin Bring Department Date
Connection Charge Paid , f—�-
j �Permit Fee: Paid $ 4 7
Check Number S"
Issued b
Tax Office y
INSPECTION
Date work started
Sufficient notification received: Date completed
Special Conditions Yes No
APPROVED:
Inspector pate