HomeMy WebLinkAboutDrain Layers Permit 1141 Strong Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT NNO, 4936
19 n `
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform the work indicated below at / y/ �. �;-yl �
at premises owned by F-: f j 's�,;'.E/; whose address is
l
and to
Lay House Drain, 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 ( ), INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date.' Est 716111_
ed Time for Completion
Permit to be issued to ✓ ` �` _i
____ _the holde_r_ of Drain Layer's License No. 0 - 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. App icant/has received
Town Permit No. and/or CHD Permit No. ff
Signed
i ensed Drain Ldyer
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:
Engineering Department Date
Connection Charge Paid Permit Fee: Paid $ /!}r, vJ
Check Number �,` i`. r/_,
Issued by
Tax Office
INSPECTION
Date work started /O 99 Date completed �O—�3"07
Sufficient notification received: Yes No
Special Conditions
----- --- APPROVED:
I spector Date