HomeMy WebLinkAboutDrain Layers Permit 30 Elderberry Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS ,
BUREAU OF POLLUTION CONTROL
d;41_ZRAIN
LAYER'S PERMIT NNo 5844
3 v 19 l
Pursuant to written applic4tion, permission is hereby granted to the
Licensed Dra.i Layer named herein to perform the work indicated below at
at premises owned byi_
whose address is 20-7 and to
Lay House Drain, Repair House Drain, Lay Main, Other ,
for �,�, 4 /r /`,<L, ,/t, occupancy or use, with
Family Units , with acres .
Type of Sewage to be connected under this permit : SANITARY SEWAOE ) ,
INDUSTRIAL WASTES ( ) , OR ( )
Connectn will be made with
Show sketch . of proposed work or furnish two (2) copies of separate drawings ,
SPECIAL CONDITIONS
Desired Starting Date U Estimated Time for Completion z
Permit to be,'issued to
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.
S i g rt e d
_ License rain 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
Engineering Dept. Date
Permit Fee Paid $ j �� Check Number L,o,
Connection Charge Receipt No. Dated -9 z
Issued by
INSPECTION f �}
Date work started ��' / / Z--- Date completed .
Sufficient notification received: Yes No ` .
Special Conditions 30
APPROVE . �0 / 9L
nspector Date