HomeMy WebLinkAboutDrain Layers Permit 11 Stiles Court TOWN ` OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
v�
� J O DRAIN LAYER'S PERMIT 0 5 767
Pursuant to written application, permission is ere]�y g�f�ted to the
Licen ed, D n /ayyr named herein to perform the work ind cated belo� at /
at r;e.mises ow d by G4f'ls'Tr
whose ddres _ is - ah o�
l ,,Gr. or and to
f Lay House Drain, Repair Huse Drain, Lay Main, Other ,
for occupancy or use, with Zf
Family Units , with el acres. —T
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.
SPECIAL CONDITIONS n
Desired Starting .Date 2, Estimated Time for Completion
Permit to be issue to / iONsn2
the holder of Drain Layer's License No Z O Permit will expire thirty
(30) days after date of issuance. The undersigned Drain Layer her 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
Permit CHD Permit No.
Signed CQ�J
L ens d Drain Layer
The above named Drain Layer has a val d license issued by the State of
Connecticut and has filed a satisfactory bond and insurance policy in the
name of the Town of South- Windsor :
g ' eer g Dept. Date
Permit Fee Paid $ ^�Ud Check Nu ber. q
Connection Charge Receipt No. 4-lb3 ated 51Z' / z
Issued by
INSPECTION
Date work started. Da a completed
Sufficient notification received : es No
Special Conditions
APPROVED:
Inspector Date