HomeMy WebLinkAboutDrain Layers Permit 59 Saddleback Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 4726
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Pursuant to written application, permission is hereby granted to the Licensed--Drain Layer
named herein to perform th work indicated below, at 40r5,1 S
at premises owned by ;�f�s x address is
and to
Lay House Drain, Repair House Drain, Lay Main,
for Other
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
Desired Starting Date Estimated Time for Completion
Permit to be issued to �Zl/vw
the holder of Drain Layer's License No. 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 s1 d'e thereof. Applicant has r�qeived
Town Permit No. and/or CHD Permit No.
Signed
VI!,j I
LicensedlDrain Layer
The above named Drain Layer has a valid liceA�'issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in e name of the Town of South Windsor:
Angfneeiling Department
Connection -Charge Paid A/f Permit Fee: Paid $
Check Number,
Issued by
Tax Office
INSPECTION
Date work started 7- j��- Date completed, Z7
Sufficient notification received: _/__�-`Yes No
Special Conditions
APPROVE
Inspector� Date