HomeMy WebLinkAboutDrain Layers Permit 26 Elderberry Lane TOWN OF SOUTH WINDSOR
DEPARTM$NT OF PUBLIC WORKS
BUREAU OF. POLLUTION'CONTROL'
DRAIN LAYER'S PERMIT 5821
19 �2
Pursuant- to written application, permission is h eby granted to the
L_�cer�sed Drai"aver named herein to perform the work indicated bellow at
0 2(�, cuc n(y* at premises owned by
whose address is nld ►) and to
Lay House Drain, Repair House Drain, Lay Main,; Other ,
for occupancy or use, with
Family Units , with acres
Type of Sewage to bex,.onn-ected under this permit : SANITARY SEWAGE ( ,
INDUSTRIAL WASTES ( ) , OR ( . )
Connection will be made with dlG
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL .CONDITIONS
Desired Starting Date C6 C, Es`tiigate((d ,Time for Completion
E Permit to be issued to 0-1 C
€ the holder of-Drain .Layer's L nense No `20 Permit will expire thirty
.aft"er :datetof issuance. The undersigned Drain Layer hereby agrees
;to all the terms' and_ conditions set. forth in the permit and the reverse side
taiereof. ;Applicant hasjrdceived Town Permit No. and/or
CAD Permit No
S e d { ( -�-�
Licensed- rain . Layer
The above named Drain Layer has a valid license .i,.ssued by the State of
Connecticut and has filed a 'satisfactory bond and insurance policy in the
name of the Town of South. Windsor:
E gineering Dept. Dat-611.�e _
Permit Fee Paid $ 2��� OU Check Number
Connection Charge Receipt No. � Dated V
issued by
INSPECTION p
Date work started ,-6. z Date completed ��' Z./ /Z
Sufficient notificati rece .vea; Yes No
Special 'Conditions
AP P RJc
Inspector Date