HomeMy WebLinkAboutDrain Layers Permit Lot 49 Stiles Court TOWN OF SOUTH W1 N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL p A
DRAIN LAYER'S PERMIT o 5841
41
19 q7
Pursuant to written application, permission is/hereby granted to the
Licen/�ed Drain Layer named ,herein to perform the work indicated b low a
at premises owned y /WD q"
whose address is a
ST8 /i Sd J !- and o
Lay House Drain, Repair Irouse Drain,, Lay Main, Other ,
for rlw/V occupancy or use, with s/,/,l
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 nor furnish two (2) copi s of separate drawings.
SPECIAL CONDITIONS S // lb SIN O e0'
Desired Starting Date 2. Estimated Time for Completion
Permit to be is sued to `7�ok?, a5a�C/e S
the holder of Drain Layer's License V. 2.og830 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 . 412 ZZ and/or .
CHD Permit No. .
Signed
Licen d Dr n Lager
The above named Drain Layer ,has a val license is u d by the -State of
Connecticut and*'h�#s filed a satisfJcN
and and insurance policy in the
name of the Town', of South Windsor:
gi ing Dept. Date
Permit Fee Paid $ r� ,C> 1Cum r
Connection Charge Receipt No '7 Dated -9 -0
Issued by ZA vZZ,?Z
t.
INSPECTION
Date work started Date completed
Sufficient notification received: es No
Special Conditions
APPROV
nspector Date
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