HomeMy WebLinkAboutDrain Layers Permit Lot 57 Stiles Court ii"'�*p.ry•R!! t ,V;. 5.y v,r:..ez'sry <.y'- F� hjYk�1."`*::Y'E'Y 'e; ..
_ S
. TOWN Of SOUTH Wl N DSOR
z
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL c Q
z DRAIN LAYER'S PERMIT N'0 5868
19 �Z
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named. herein to perform the work indicated below at
# �
-/,� "`2 ClS � at ,premix s owned by _rAo)�--
whose address is ofD. to
Lay House Dra n, 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 (PI ,
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with
Shaw sketch of proposed work or furnish two (2 . copies of separate drawings.`
SPECIAL CONDITIONS (� OH `4!'1 11W
Desired Starting Date —gZ: : Estimated Time for Completion
Permit to be issued to _ . alcl�s
,the holder of Drain Layer 's License NW. Zogg,�o Permit will expire thirty
(30) days after date of issuance. The undersigned D'ra,in Layer .hereby agrees
to all the terms and conditions setforth, in the permit and the reverse side
thereof,* Applicant has received 'Town Permit No. 57169 and/or
CHD Permit No. .
Signed _glVCPA-
Lfcen DraXzf Layer
The above named Drain Layer has a valid 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:
Eng eering Dept. Date
Permit Fee Paid '$ 42_� .00R Check Number
Connection Charge Receipt No. 41/R(10, Dated
Issued by
INSPECTION
Date work started / Z— Date completed Z`/W �
Sufficient notifica on rece ve . es No
Special Conditions
APPROVED:
Inspector
T