HomeMy WebLinkAboutDrain Layers Permit Lot 45 Rockwell Cour TOWN OF' SOUTH W!N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
0 5887
DRAIN LAYER'S PERMIT
z � , i 9
Pursuant to written application, permission is hereby granted to the
LiA7 ed Dr in ayeF n ed ein o perform the work Indic t dt�el tat r' mises own d by `
whose address i s ,,f... ',. cf,�d� ' ! N,
to
Lay House,, Drain,, Repaf House Drain, Lay 'Main, Oth rT ',
for �1`9l�, ;i ��_ occupancy or use, with
Family LTniti, with acres.
:Type of Sewage to. be connected under this permit : SANITARY SEWAGE
INDUSTRIAL WASTES:`(. , OR (F )
Connection will be made with / ;S_0K
i_
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date f Estimated Time for Completion
Permit to be` issued 'to ` , -) �S
the holder of Drain Layer,'s License No. ;< P-ermit. will expire thirty.
(30) days after date of .issuance. The 'undersigtned Drain: Layer hereby agrees
to all the te`.ms ' and conditions set forth in the p;e and the reverse side
thereof. Applicant has received Town Permit No. - and/or
C.HD Permit No.,
ne
1 g _
ice a ain Layer '
The above named Drain; Layer has a .v,aalid license is ed by the- State- of
Connecticut and has filed a 'sat isfactory bond and insurance ,policy in the
name of the Town of South Windsor:
Engineeringz_ Dept. Date
Permit Fee Paid $ Cheek Number
Connection Charge Receipt No. G j�, Dated
Issued by
INSPECTION q
Date work started / Z� /. Date completed
Sufficient notification rrecely es No
Special Conditions
AP P R
Inspector Date