HomeMy WebLinkAboutDrain Layers Permit 35 Pheasant Way \` TOWN OF SOUTH i Ph�4s�n��a
•�`��' W N DSOR `t
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT "• :�rm r,
r.. 2�Y
� C�oac rl�- 19
Pursuant to written application,upermission
named herein to perform the work indicated below at hereby g�nted.� he Licensed Drain Layer
at premises. owned by
whose address is
Lay House Drainf, Repair House Drain, y and to
for G!�� r n1Cr La Main,
,'� , to s)k)- r. 1t i_ Other':
Family units, with i acres. occupancy or use with f
Type of Sewage to be connected under this permit: SANITARY SEWAGE (✓1, INDUST
WASTES ( ), OR ) RIAL
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
Permit to be issued to
the holder of Drain Layer's License No, r
after date of issuance. The undersigne Drain Layer hereby agrees xtorallhtheyterms ands
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No. and/or CHD Permit No.
Sined
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:
, t
Engineering Department Date
Connection Charge Paid C,C)c . �' ��
Permit Fee: Paid $
\ Check Number
Issued by
Tax Office
.INSPECTION
Date work started �`7 - �� /jr �n_ 90
Sufficient notification receAd: Date completed l-j" j�
Special Conditions Yes No
APPROVED: r
ate
Inspector