HomeMy WebLinkAboutDrain Layers Permit 1030 Strong Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
t) �� BUREAU OF POLLUTION CONTROL
� � \\ DRAIN LAYER'S PERMIT o, 4866
19
Pursuant to writte' application, permission is hereby granted" to the ,icensed Drain Layer
named herein to pefo the;work indicated elow;+at 1 =��� ,,'r ` .•, �, f ��
a premises owned b �;� ,t<, 1 x. , LC '"y,. V% whose address is
and to
Lay House rain,for RLpair House Drain, Lay Main, Other Family Units, with acres. occupancy or use, with
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.
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SPECIAL CONDITIONS L Z ` o ?• /') �"
D-5-- t�J r rye--7
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No.X y Q,d ,r/. Permit will expire thirty (30) days
-after-date of i9su4 . -- The-undersigned& Dra—h-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. and/or CHD Permit No.
Signed`
Licensed Drain 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:
((\ i
En ineering Depar�,ty nt Date
Connection Charge Paid Permit Fee: Paid $
Check Number
7
;r elf Issued by
-`-- - Tax Office e.
INSPECTION
Date work started B --13- 87 Date completed
Sufficient notification received: Yes No
Special Conditions 57nah--D /J m&". tfiT C0 47Qz PVMp- 56/1_ /S 04a-
G ILL. l*VF70 1tilG /AJ 5WAJD cl/e.200 /P
APPROVED.: _.. _ - ._- A /a-g7
Inspector Date