HomeMy WebLinkAboutDrain Layers Permit 52 Sally Drive TOWN OF SOUTH Wi N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT Q 40 14_
v 3 19J6
ct)
Pursuant to writ an application permission is her by: granted to the Licensed Drain Layer
named herein to .perform or ca d-b44ow at
at premise's owned; by whose address is
and, to.
Lay House Drain,' House Drain,'` " 'Lay Main, Other ,
for occupancy or use; %th
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWACE ( ), 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
the holder of.Dray, ..I+e3' x's_.aee.1 •., _ :s: re,x Pitt -wad.. a it 7-tt l*l y .'-30`)Asys
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
License&Drain:Layer
The above named Drain Layer has a .valid .license .issued by .the ' taite` of Connecticut and
has filed a satisfactoFry bond- and insurance policy in "the name of the Town of;$outh Windsor:
Engineering Department Date
Connection C rge Paid ` 1A .�6 Permit Fee: Paid $ 11311 /-57
Check..Ngkber
Issued by 141XJ
-7 Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date