HomeMy WebLinkAboutDrain Layers Permit 1404 Arthur Drive TOWN OF SOUTH W1 N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 3964
Pursuant to written application, permission is h reby gran d o the L ensed Drain Layer
named herein to perform the rk i�dicate below at
at premises owned by whose address is
and to
Lay House Drain, Repair House Drain, ` 'Lay Main, �_ Other ,
for occupaicy or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE( ), INDUSTRIAL
WASTES ( ), OR O 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 Uyer's -License No. Permit will expire thirty. (3.0.)-'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 CHD Permit No.
Signed
Licensed 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,, n the name of the Town of South Windsor:
Engineering Department Date
Connection Charge Paid C/ ,Permit Fee: Paid $ , U p
J Check Number
•
Issued by
Tax of TIT;
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector pate