HomeMy WebLinkAboutDrain Layers Permit 166 Rosemary Lane -- TOWN OF SOUTH W1 N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
,
DRAIN LAYER'S PERMIT N2 5346
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Pursuant to writt en�appljej
on, permission is hereby granted to the Licensed Drain Layer
named herein to perform the work indicated below at 7 ZS--MAA,( /-4 -
at premises owned by /J �,c cc, whose address is
/�/trNCUcs r a• and to
Lay House Drain, Repair House Drain, Lay Main 'Other
for 9 ,
with 5 ,,jG:,_E
Family Units, with acres. occupancy or use,
Type of Sewage to be connected under this permit: SANITARY SEWAGE (v), INDUSTRIAL
WASTES ( ), OR ( )
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate dregs.
SEE AT TA 04Ea
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SPECIAL CONDITIONS -ems
Desired Starting Date rts�k Estimated Time for Completion J,.jy
Permit to be issued to A L
the holder of Drain Layer's License No. z_ 08�l6 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
Licen ed Drain Layer
The above named Drain Layer has a valid lq
iss a by the State of Connecticut and
has filed a satisfactory bond and insurance poth name of Town of South Windsor:
9 �z
neer g partment Date
Connection Charge Paid 5 Fee: Paid $ 1 , 6 0
ck umber E? 1Issued b
Tax Office `
INSPECTION
Date work started ,9/1 ��� Date completed �j�$ �
Sufficient notification received: vies No, '
Special Conditions
APPROVED: 6-
Inspector Date
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