HomeMy WebLinkAboutDrain Layers Permit 1601 Arthur Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMITb�
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Pursuant to written application, permission is h eby ranted to the License Drain Layer
named herein to perfo th or indi ed low at,. �t.d -- - Cd
at premises 'owned by r whose: address is
_ and to
Lay House Draiiz, Repair �House 'Drain, `Lay• in, '' Other
for occupancy or use;with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ), INDUSTRIAL
WASTES ), OR C )
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 :L cens'e No: ; Permit t311 expire thirty (30) 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.
- z
Signed
Liceri:sed Drain Layer
The above named: Drain Layer hps a, valid license issued by.the state of'Connecticut and
has filed a satisfactory bond and insurance policy. n the name of' tle Town of South Windsor:
Engineering Departm nt Date
Connection Charge Paid 16
���� tl D r` ' Permit Fee: Paid $ �. p`Q
Check Number 1 D �
Issued by ,
Tax df fice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED':
Inspector Date