HomeMy WebLinkAboutDrain Layers Permit 0601 Arthur Drive TOWN : OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT X
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Pursuant to written application, permission is h reby ranted tIZA o the Licensed Drain- Layer
named herein to. perform the work indicated below at
at premises owned by J w ose address is
and to
Lay House Drain', Repair House Drain, Lay Main,
for Other
occupancy or use, with
Family Units, with acres:
Type of Sewage to be connected under this permit: SANITARY SEWAGE O, INDUSTRIAL
WASTES O, OR (` }
Connection will be made with
Show sketch of proposed, work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit- to be issued to
the holder of Drain'T,ayer's'-License No. . Permit will expire:thirty (39) 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 C:HD Permit No.
Signed
Licerised 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'' f South Windsor:
Engineering Depa tment Date
Connection Charge Paid Permit Fee: Paid $
Check Number
jri Issued by
' Tax ffice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector pate