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HomeMy WebLinkAboutDrain Layers Permit 121 Pheasant Way TOWN OF SOUTH WI N DSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT .No 5855 Pursuant to written applicati8n, permission is hereby granted to the Licensed Drain Layer n,ame4 herein to perform the work indicated below at at pre ises owed by J GO h S T` whose address is 6 S $ 4.1 i'h oti s --/ and o Lay House Drain Repair Her-use Drain, Lay Main, ether , for oc.cupancy or use, with j -F Family Units , w1th acres. Type of Sewage to be connected under this permit : SANITARY SEWAGE . ( INDUSTRIAL WASTES ( ) , OR ( ) Connection will be made withb/Z Show sketch of proposed work or furnish two (2) copies of separate drawings. SPECIAL CONDITIONS Desired Starting Date stimated Time for Completion Permit to be issued to the holder of Drain Layer' s c'ens No " ZZfg_?0 Permit will expire thirty , y - . undersigned ` Layex hereby aagrees(30). da s after date of issuance,. Th Drain to all the terms and conditions set forth in the permit and the reverse side thereof. Applicant has received Town Permit No. �' S> and/or CHD Permit No, Signed is ed D in Layer The above named Drain Layer has a valid license' iss ed by .the . State of Connecticut and' has filed a satisfactory bond and- insurance policy in the name of the Town of South Windsor : EngFe erring Dept,. Date Permit Fee Paid $ �, ©O Check` Numr � 1� Q Connection Charge. Receipt No. y Dated Z_1 ,_9 Issued by �J INSPECTION 177 Date work started Zn- zl�r 9Z Date completed Sufficient notificion rece3 e : TI es No Spec- al- -C-o it.ions. - 1 nspector Date