HomeMy WebLinkAboutDrain Layers Permit 36 Thomas Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF PDBLIC WOW
BUREAU OF POLLUTION CONTROL
DRAIN. LAYER'S PERMIT nn_. • .. ja! SJi:f
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pursuant to Written application, Remission is hereby granted to the Licensed Drain Layer
mixed herein to perform the k indicated below at
a[ pz Se owned by whose address 1a
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Lay mouse Dzefn� _,Repair mouse Drain, Lay Main. Other
fox Can occupancy or use, with
ily Units, with ee.
Type of Sewage to be connected under this permit} SANITARY SEWAGE E j�), INDUSTRIAL
WASTES ( ), O8 ( ) Connection will he made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
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SPECIAL CONDITIONS ��Q�/Jp/ �/, ✓ ' r�G 1� ���u�`(�
Desired Starting Date Eatimaced Time Fox CompleHov /.. g<i
Permit to be issued to ,r$�d.��- /�nC /d�;� z
the holder of Drain Layer License No. 110c7' L r Permit will expire thirty tiv) days
after date of issuance. The undersigned Drain Layer hereby agrees to all the term and
conditions set forth in the permit and the r side thereof. Applicant has. received
Town Permit No. and/or PULL Co mic No.
T
Signed I %' u q �<
Licensed Drain Layer
The above named Drain Layer has a valid licence Issued by the State Of Connecticut and
has filed a satisfactory bond and insurance policy in the worse Of the Tow of South Windsor:
' Sngineexing Depet en[ pate
Connection Charge Paid Permit Fee: Paid $
Check
Numbe
Issued by
Tax Office n / (�
INSP
Date work p Date completed O ' zb - )/
Date work started � Z G //
SpecialeCo ditifica[ian received: - Yea Na /
Special Conditions
or Data
APPT
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