HomeMy WebLinkAboutDrain Layers Permit 88 Rugby Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
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DRAIN LAYERS PERMIT i' 0 5883
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Pursuant to written application., permission is hereby granted to the
' censed Drain Layer named herein to perform the work indicated below at
A y �/r�fi?As at premises owned by /,�i //_ gVs
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
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS O TTr
Desired Starting Date / 9z Estimated Time fo: Completion
Permit to be issued to Jzj �_ XC/ ,,(�IGU4iyl sS
the holder of Drain Layer 's License No. ao S 5`3 & 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 ��
Licensed Drain Layer
The above ,name.d Drain Layer has a valid : license issued by the. State of
Connecticut and has filed a satisfactor bo d and i s , ranee policy in the
name of the Town of South Windsor
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n inee g Dept. Date
Permit Fee Paid $ 25� 00 Check umber
Connection Charge Receipt No. Dated /r9-C-Qp�
I-ssued by ��� _
INSPECTION
Date work started 2— Date completed
Sufficient notification rece ve : es No.
Special Conditions
Inspector Date