HomeMy WebLinkAboutDrain Layers Permit 38 Tallwood Drive TOWN OF SOUTH WINDSOR
M1N" DEPARTMENT OF PU➢LIC WORKS
\� BUREAU OF POLLUTION CONTROL 1kT
DRAIN LAYER'S PERMIT ,Rfe. 4446
Pursuant to written application, pexmiaeioa is h� bX-great d to the L e eed Drain Layer
mad M1erein to porfo the myrk in Cad below at ' )}( d Q� {�r� ��11cc L?rt^Y.f
at premises owned by ' fiy) ; \ I1�..?J h I whose address to
�r a to
Lay Ibaee Drain, Repair }louse Drain, Lay a1M Other
for occupancy or use, With
Family unite, with acres.
Type of Sewage to be connected order this permit: SANITARY SEWAGE O. INDUSTRIAL
WASTES O. OR O Connection Will be made with "
Show sketch of proposed work or furnish two (3) copies of separate drawings.
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G' S pe�F gyp, o " ?vim
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SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completloa
Permit to be issued to 7" G/gC .('GR — ,T�i PS — nc- -
the holder of Drain Layer's L ZT Permit will expir n,Fne chlrC 30)sE 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. and/or COW Permit We.
Signed //at%iL.
T� License Drain Layer
The above named Drain Layer bad a valid license Issued by the State of Connecticut and
has filed a Satisfactory bond and insurance policy;in thmnedsa of the Town of South Windsor.
ahgmeering ne paxtmeae pate
Connection charge Paid U 1 Permit Pee: Pais 6 TT OG
Check Number _
0I .fic �' ���� Issued by
Tax Office
INSPECTION
Date work started Dace completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date