HomeMy WebLinkAboutDrain Layers Permit 40 Spinners Run TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT V i N2 5808
Pursuant to wr tten application, permission is hereby granted to the
_Licensed Drain La r named herein to perform the work indicated b low at
fpl- /� �n,Qn ✓ti at premises owned by
whose a ress is and to
Lay House Drain, ,l Repair Ho se 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.
S ECIAL CO IONS rT
Desired Starting Date Es y timm/ated� Time for Completion - �
Permit to be issued to
the holder of Drain Layer's License No. ^cs"�� 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 � J
Licensed Drain Layer
The above named Drain Layer has a valid license issued by the State of
Connecticut and has filed a satisfactory b nd and insurance policy in the
name of the Town of South Windsor:
/,4/?,
in e n Dept . Date
Permit Fee Paid $ Z S-UO Chenn umber //3
Connection Charge Receipt No. ¢1 9 - D ted 7 ,Z4 A9Z
Issued by , 71Z4- /9
INSPECTION 77
Date work started Date completed
Sufficient notification rece ve : yes No
Special Conditions
4
APPRO Z -g
nspector Date .