HomeMy WebLinkAboutDrain Layers Permits 20 Ridgefield Drive v.R". /•. ... h ....p• ,A .. ..�.,,I,, _ - '4. 1-..y.. 4 „a.> .t.'tl.. ;2•xF" :e7F� .Mt` #.
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TOWN Of SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT X0
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Pursuant to written applicati permission is 1hereb gr ted to he Licensed Drain Layer
named herein to. perfa •he wor indica belo at l�f 6:
at premiseg. owned by whose-:address is
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Lay House Drains ... . •Repair' Ouse• Dtaia, ,L.hy,: iti,' othe3£ ,
for — occupant of use,f with
Family Units, with acres. .
i
e of Sewage to be connected under this
�'P g permit SANITARY SEWAGE �f,r INDiTSTRIAi,
WASTES Os OR t ) Connect ion. will be made.:with j
Show sketch of pro osed work or furnish two (2) copiAs of separate drawings.
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SPECIAL CONDITIONS ,
Desired Starting-Date Estimated-Time .f r Completion: :..
Permit. to be issued to (f
holder...o_f_.. ..... } itK.( )M"ay&,
after date of issuance. T#ie 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 CHI) Permit No. i
Signed.
y •Lic°eris-ed.-•Drain Layer
The above named Drain-.Layer has a valid license issued" by`the Mate of Conuebticut and s
has filed a satisfactory bond and insurance,pplicy, n the nfatge ;of, ;th h!owri' of Sour Windsor:
-Engineering ••epartmerit r ;Date
P 6/ �} Permit Fee:' paid $ � ,
Connection Charge Paid' &
Check Number • ;a,�•y�,� .
Issued by 1
Tax Office
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INSPECTION j
Date work started Date completed
Sufficient notification received: Yqs No
Special Conditions
APPROVED:
Inspector pate
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