HomeMy WebLinkAboutDrain Layers Permit 701 Nutmeg Road Nort TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT O 4.51.0
19 '
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform tl e work indicated below at
at premises owned by v C}�,�,���, �;� { ��;��,d��.. �} 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 ( ) CQnn�ction will be made with
rf
Show sketch of proposed work or furnish two (2) copies of separate drawings.
we u/
SPECIAL CONDIT NS
Desired Starting Date Estimated Time for Completion
Permit to be issued to To; P/-/ 1�Jo.so
the holder of Drain Layer's License No. �e 7 Sq? . Permit will expire thirty (30) 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
Lid nsed 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 polio in the nme f the T of South Windsor:
f
Engineering Departhdent Date
Connection Charge Paid .%) j)!) . ('? Permit Fee: Paid $
Check Number
Issued by
Tax Office
INSPECTION Date work started Y' 16' — K Date completed �Z -
Sufficient
Sufficient notification received: _Z Yes No . --'!
Special Conditions
APPROVED-
Inspector pate