HomeMy WebLinkAboutDrain Layers Permit 277 - 297 Oakland Ro MTN
TOWN OF SOUTH. WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT NAIL 4932
' 19L%
Pursuant to written application, permission is__-hgreb ranted ta, the Licensed Drain Layer :
named herein to perfo the wor� i 4icated bel w,;at
at premises owned by - ; , worse dres is
i �� -' , ( and to
Lay House Drain, -Repair use Drain-, - Lay Main, Other ,
for _ (�;) -�rt�i'�r'',� �j+1 C(f i_L LLIjI(fit),a L,4 , occupancy or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (Y�. INDUSTRIAL
WASTES( ), OR ( ) Connection will be made with
99
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 WT i
the holder of Drain Layer's License No. Permit wi expire thirty (30) days
after date of issuance. The undersigned rain Layer hereby agr to all the terms and
conditions set forth in the permit and the reverse side there Ap lic has rece2V
Town Permit No. and/or CHD Permit No. .r
Signed
Licensed 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 ' /fth'ie name of LthT%Z;f South Windsor:
llr
�
Engineering Department Date
Connection Charge Paid ±,_"�� 1 . U (� Permit Fee: Paid
Check Number �?
Issued by --' - G'`, V� ! _ o C_
Tax office
INSPECTION
Date work started Date completed
Sufficient notification received: lky No
Special Conditions
APPROV
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spector pate