HomeMy WebLinkAboutDrain Layers Permit 19 Stiles Court TOWN OF SOUTH W NDSOR
-� DEPARTMENT OF PUBLIC WORKS
C_cp< BUREAU OF POLLUTION CONTROL
� l 0 5832
\C� DRAIN LAYER'S PERMIT }`'�o
3 , 19 f\—
Pursuant to written application, permission s hereby granted to the
Licensed Dr in La r named herein to perform the work indicated below at
�G� at premises owned by \ 1 1" 7 C7/')S�
whose addre is C� S'o, (��+ o% and
R Lay House Drain,- - epair ouse Drain, Lay Main, O her ,
for occupancy or use, with :5 ��
Family Units, vrith y/ acres.
Type. o'f _ S-ewage to be connected .under this permit : SANITARY SWAGE V
INDUSTRIAL WASTES' '( }, `OR
Connection will be made with SPA VSr Sea e ,l,c»
Show sketch r� roposed, work or furnish two (2) copies of drawings.
SPECIAL C N (TTI01TS
r
De fired Starting Date, Estimated,, Time for Completion
Permit to be issu d /to d
the holder of Drain s'La er Lic nse y ,� Qd 1'ernit will 'expire thirty
(30) days after date .of, igii 4.nce-.Y - .:The -undersigned, Drain. Layer,her.eby agrees
to all the terms and conditions sect= fort-h�;,in the -permit:-'and the reverse side
thereof. Appli`ca-nt' has "received- Town 'Permit No. and/of
CHD Permit No:'`,
j Signed
Licenswfl Dr a n Layer
The above named Drain. Lay_er. :has a val l�tcens issue by the, State of
Connecticut and h'as-filed - a=-satisfactory bond: and insurance. policy in the
name of the Town of South Windsor; . » -
Engi e'erin Dept. Date
JF
Permit Fee Paid $ (}// Z,9& Check Number s
Connection Charge Receipt No . /VZZ3 Dated- �' U� 'z
Issued by
INSPECTION J Date work started l /�7
`9Z-- Date completed
Sufficient notifica=ion receiv�ec — es No
Special Conditions
A D J 2
Inspector Date