HomeMy WebLinkAboutDrain Layers Permit 0603 Arthur Drive TOWN OF SOUTH W NDSOR
DEPARTMENT 'OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
Pursuant to written application, permission is he eby ran ed t the Licensed Drain Layer
named herein to. perform .the ork ndicat d :below: t -
at premises. owned by whose address is
and to
Lay House Drain, Repair House Drain, =Lay Main,
for er Oth ,
occupancy or uses with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ), 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"'Layer!s'- `icense No. Permit will expire 'thirty"(30) days
after date of issuance. The undersigned Drain Layer hereby agrees' to all the terms
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No. and/or CHD Permit No.,
Signed
Licensed Drain Layer
The above named Drain Layer has A yalid license issued by the State of Connecticut and
has filed a satisfactory bond, and insuiaace, policy an the name;o'f the Town bf South' Windsor:
Engineering Depaftment Date
Connection Charge Paid � .7 =7 Lq t9 Permit Fee: Paid $ �.
Check Number 00:t;—
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED::
Inspector Date