HomeMy WebLinkAboutDrain Layers Permit 110 Robert Drive r- '%� '? . _
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TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL AATT
DRAIN LAYER'S PERMIT 1rNo. 4530
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform the work in ic ted below t ,
at remises owned b
P y , .�. -f�rrc i.z �.c ,4, .,..�._ . whose address is
and to
Lay House Drain, Repair House Drain, Lay Main, Other ,
for 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
%I//C
Show sketch of proposed work or furcnNotto (2) copies of separate drawings.
SPECIAL CONDITIONS , �__ -T"r 0 ff 4a.4/�
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder_ of Drain.La_y_er-Is Licsn.-se_No.. _-
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, �✓ v
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- n,the name of the Town of South Windsor:
Engineering Department Date
Connection Charge Paid Permit Fee: Paid $
Check Number
_ 'fT Issued by
Tax Office
INSPECTION
Date work started I 2 9- 87 Date completed f— ? 9 — g
Sufficient notification received: es No
Special Conditions
APPRO
Inspector Da Fe