HomeMy WebLinkAboutDrain Layers Permit 46 Partridge Lane TOWN OF: SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU'OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT Np 5761
19
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
0 'fif tRin r I-A&W at premises owned by WArVrOt. `1G lc'r-rC�L
whose address is b 4kmtCT DQ MANc leQf t'f OW40 and to
Lay House Drain, Repair House Drain, Lay Main, Other , ,
for "el 0 eac occupancy or use, with 60L�C'
Family Units, with acres.
Type of Sewage to be connected under this permit : SANITARY SEWAGE O ,
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 s'
Permit to be issued to 'Q /✓li N/� L �/v 0/Cs
the holder of Drain Layer' s License No. 7-a6 rc Permit will expire thirty
(30) days after date of issuance. The undersigned Drain Layer hereby agrees
to al 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
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 in the
name ' of the Town of South Windsor: _
En gineering Dept. Date
�-
Permit Fe Paid $ - 033 0
-e �� Check Number
Connection Charge Receipt No. Dated
Issued by
INSPECTION
Date work started L/ Date completed
Sufficient notificatiSn rece3vve es No
Special Conditions
APPROVE
In pector Date j