HomeMy WebLinkAboutDrain Layers Permit 89 Oxford Drive w-
TOWN OF SOUTH WINDS.OR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL 4'
DRAIN LAYER'S PERMIT r(,( br , 5440
. S T - , 19�)C-)
Pursuant to written application, J
pp , permission is hereby granted- to th�"iicensed Drain Layer
named herein to perform the work indicated below at # ZG
at premises owned by / k' (cN whose address is
0 and to
Lay House Drain, ,- Repair House Drain, Lay Main, Other
for S 1 occupancy or use, with
Family Units, with acr s.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (0,' INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
J
Show sketch of proposed work or furnish two (2) copies of separate drawings.
l I
P
SPECIAL CO DITIONS
Desired Starting Date 5_ 1 y d Time for Completion I CA,
Permit to be issued to •Jc�,, A L , ��,. Inc
the holder of Drain Layer's License No. Z�.r4/E, 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 r
Licens Drain Layer
1
The above named Drain Layer has a valid license issued l y the StAte of Connecticut and
has filed a satisfactory bond and insurance policy in the nme of the Town of South Windsor:
�/•3/� 5 -y Ur/C/
9 -w Engineering Department Date
Connection Charge Paid ('�� � Permit Fee: Paid $
4�- Check Number
Issued by
Tax Office
INSPECTION
Date work started' Jd Date completed S C c)
Sufficient notification received: _�_ Yes No
Special Conditions
APPROVED:
nsp ctor pate