HomeMy WebLinkAboutDrain Layers Permit 49 Oakland Road TOWN OF SOUTH WINDSOR
G) DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 3 ,�` 0 0
19
Pursuant to written application, permission is hereb T
anted tj the Ll.c nsed Drain Layer
named herein to perform the work indicated below at
at premises owned by whose address is
V C- J, 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 % , Estimated Time for Completion
c=
Permit to be issued to C)
the holder of Drain Layer's License No. 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. a
Signednj
Licese4d 1n yer
f}
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 phe ame the Town of South Windsor:
, �,, 1,010)
I Engineeri g Department Date
Connection Charge Paidld- Permit Fee: Paid $
Check Number Cyt:t'��1
Issued by
Tax Office
INSPECTION
Date work started ��Q-- Z. �9 Date completed
Sufficient notification received: _des No
Special Conditions
APPROVED:
Inspec or pate