HomeMy WebLinkAboutDrain Layers Permit 15 Ronda Drive TOWN OF SOUTH WI N DSOR 9 b
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL pp nn
DRAIN LAYER'S PERMIT :, O 50t16
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
N a Pt 7 at premises owned by C&.M,_ Q Vzo N
whose address :is l o"J6 A Q rx—
and to
Lay House Drain, Repair House Drain, Lay Main, Other t/ ,
for occupancy or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit : SANITARY SEWAGE M ,
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with
Show sketch of proposed work or fern-ish two (2) copies bf separate drawings_.
SPECIAL CONDITIONS - 13uIIt1In5
r _ IZPC�c.�r Se� � i �r �� SeW - r L"►rl
Desired Starting Date 7. Itt Estimated Time for Completion -7 _ I(/-ri2
Permit to be issued to o o
the holder of Drain Layer's License No. 2-6-'-)61L Permit will expire thirty
(30) 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,
CHD permit No.
Signed
icen"seDran' dye
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:'"
' 'Eng _ee ing Dept. Date
Permit Fee Paid $ 2 Check Num r �.
Connection Charge Receipt No. Dated
Issued by _
INSPECTION
Date. work started Date completed j-=9Z
Sufficient notification rece ve : es No
Special Conditions
APPROVED. � Z
Inspector Date