HomeMy WebLinkAboutDrain Layers Permit 8 Perrin Lane (4) 4
TOWN OF SOUTH WINDSOR
DEPARTMENT OF- PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT NO 5781
, 19 z—
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
,407- / j fry"</ -e1 at premises owned by -71 M-T 6VAZST-1Z4e0`0,/
whose address is 16 S$ ¢//i and to
Lay House Drain, Repair House Drain, Lay Main, Other ,
for �iV6-1-f occupancy or use, with
Family Units , with acres .
Type of Sewage to be connected under this permit : SANITARY SEWAGE
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with C S,J>A 3�
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL COND TIONS
Desired Starting Date $ /S Estimated Time for Completion f �y
Permit to be issued to _i"^ /Yl- ..��� Cms✓3'T/t�-teTi�a�i✓
the holder of Drain Layer ' s License No. Z p 824 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
—Z��_W_� �
censed Drain Xayer
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 :
lv Engineering Dept. Date
Permit Fee Paid $ Check Number
Connection Charge Receipt No . Dated
Issued by
INSPECTION
Date work started Date completed
Sufficient notification received : es No
Special Conditions
APPROVED:
Inspector Date