HomeMy WebLinkAboutDrain Layers Permit 79 Steep Road (3) O�
� 5 TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF'POLLUTION'ZONTROL
DRAIN LAYER'S PERMITO 5889
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Pursuant to written application., permission is hereby granted to the
Licensed Drain Layer named herein. to perform; the work indicated below at
_1 e cr at premises owned by �
whose: address is T" and to
.,
day lou a Dr in, Repa ouse Drain, Lay Main, Other . ,
for . occupancy or use, with
FamA y Units, with / acres.
Type of Sewage to be connecte under this permit: SANITARY SEWAGE ( ,
INDUSTRIAL WASTES ( ) , OR { )" R ._71V _6
Connection will. be made with
Show pketch of proposed work or Furnish two (2) copies f separate drawings.
9�5a>!ay, 00 7 � PCL
N
SPECIAL COND-ITION'S QS 14A IOU ST I& l Ga
Desired: Starting Date Estimated Time for Completion i
C, Z
erittit, to be issued to42 S 5CUUJK
the holder of Drain Layer's` License No. oz&_�z Permit will expire th ri ty
(30)., days after date o.f issuance. The undersigned Drain Layer hereby ag�ree:s
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
Licensed Drain Layer
The above named Drain Layer has a vali license issued by the..,'S-tate of
Connecticut and has filed a satisfactory and and insurance policy n the
name of the Town of South Windsor:
1Zh0j1z ,_
ng'in ing Dept. Date;
Permit Fee Paid $ .00 Ch ck Number
Connection Charge Receipt No. A ated ) Q
Issued by
AnANNED
INSPECTION
Date work started JZ L Date completed
Suf f icient notif ication receive3: _ es No
Special Conditions
APPROVED•
NEDInspector Date