HomeMy WebLinkAboutDrain Layers Permit 772 Pleasant Valley TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 6267
19
Pursuant to written application, permission is hereby granted to the
Licensed Dr Layer na a he n to perform the work ind3„r, ted p�1QQw�a
p&65t
Y Gt at premises, owned by p Wc�!$
. :address is -and to
v ;y o s. Drai , Repair House Drain, Lay Main, Other ,
fir �- occupancy or use, with .Z
F m nits, with acres .
„ of Sewage to be connected under this permit : SANITARY SEWAGE ,
INt D WASTES ( ) , OR ( )
Connect an. will be made with
Show sketc roposed work or furnish two (2) co ies f separate, drawings .
AJ
A REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONSlGyr c.....
Desired Starting Date : 1< Estimate Time for Completion
Permit to be issued to rG {
the holder of Drain Layer ' s License No. Permit will expire thirty
( 3'0) 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
C14D Permit No . \
Signed
Licensed Drain Layer
The above named Drain Layer has a vak d 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 : oe
z 4--�
ng neering Dept . Date
Permit 'fF ;e ":Paid `$- r .QQ Check Number 1,9
, Connection Charge Receipt No. 5� Dayed d�jfa�-QS
Issued by
INSPECTION q
Date work started " 27- / Date completed , g 5'
Sufficient notificafion ece ve es No —��
Special Conditions
APPROV.
Anspector Date
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