HomeMy WebLinkAboutDrain Layers Permit 1503 Arthur Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT a� 3882
19�
Pursuant to written application, permission is hereby ranted t the Licen ed Drain Layer
named herein to perform.the work. �dic ed below at / -,� 1� a
at premises owned by ! .whose 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 ( ), INDUSTRIAL
WASTES ( )� 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 License No,. Permit will expire thirty (30) days
after date of issuance. The undersigned Drain Layer Hereby agtees 'to all the terms and
conditions set forth in the permit and the reverse side thereof. Applicant'has �rece'ived
Town Permit No and/or '
CHD Permit No.
Signed
:- Licensed,Drain. Layet
The above named Drain Layer has; a valid .license i§sued' by'the State: of Connecticut and
has filed a satisfactory bond and insurance policy ,in..tthhe ria e.of the Town' of South,Windsor:
Engineering Department Date
Connection Charge Paid A7 4 �� g mit Fens Paid .
Check Number �Q
'Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date