HomeMy WebLinkAboutDrain Layers Permit 65 Saddleback Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT °7,/�
4.727
65-joddl�.�bq , 19,i
Pursuant to written application, permission is hereby anted, o the Licensed Drain Layer
named herein to perform thg work indica ed below at
at premises owned by / 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.
r,•r
SPECIAL CONDITIONS
Desired Starting Date / Estimated Time for Completion
Permit to be issued to d �/ Z 6
the holder of Drain Layer's License No. ; Permit will expire thirty (30) days
after date of issuance. The undersigned Drain Layer by agrees to all the terms and
conditions set forth in the permit and the reverse si a hereof. Applicant has receiyRd_.__
Town Permit No. and/or CHD Permit No.
Signed
Licensed ain Layer
The above named Drain Layer has a valid lice a issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
ZZE21 K� -X� 2�512
Engi ee ing Department Date
Connection Charge PaidIlex. Permit Fee: Paid $ Z)/ LCh �d
Check Num
Issued byrrr�-��� �n
/ vV
Tax Off ice
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INSPECTION /Date work started �'�/ 7— OD7 Date completed
Sufficient notification received: Yes' No
Special Conditions
APPROVED:
Inspector pate