HomeMy WebLinkAboutDrain Layers Permit 59 Stanley Drive t4 / ..pt ..a :'�.'._ '.�i?k'�"'k+R_ ,1`j aV 7'CT.^ { Y n -
TOWN Of SOUTH Wi N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT , 4367
5 19 / 1
Pursuant to written appli ation, permission is ereby grant to t Licensed Din Layer
named herein to. perfo he rkL�Indi ted below at L k se Drain y
at premises owned by (,� hose 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 5 Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
eWl— --� `�:tNArL 1?
SPECIAL CONDITIONS
Desired Starting Date Estimated Time f pl�etion
i
Permit to be issued to ' vc '
the holder of Drain Layer's License No-. Permit 11 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
Lice s'ed D: 'n Layer
The above named Drain Layer has a valid licZis by the State of Connecticut and
has filed a satisfactory bond and insurance poli of the Town of South Windsor:
/ r;. 3
ngineering Department Date
Convection Charge Paid Permit Fee: Paid $ j- 0
- Check Number (� �-
�' �
�1 /Issued by
Tax Office
INSPECTION
Date •work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date