HomeMy WebLinkAboutDrain Layers Permit 1603 Arthur Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
1
Pursuant to written application, permission is h reby,granted to t e License Drain Layer
named herein to perform the wo k i icat d below: at
at premises owned by whose address is
and 'to
Lay House Drain, Repair Mouse Drain, Lay Main, pth8r
for occupancy or use, with`
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE , f.
WASTES ( ), OR INDUSTRIAL
Connection willbe.made with
Show sketch of proposed work or furnish two (2)" c0pies of separatedrawings.
SPECIAL CONDITIONS
Desired Starting Date Estimated-.2ime for Completion
Permit_ to be iss6e'd to` ;
the holder of Drain Layer's license No: Permit will iipire thirty (S'0) days
after date of issuance. The undersigned Drain Layer hereby agrees ". o ail the 'tertns `and
conditions set forth in the permit and the reverse side thereof.- Applicant has received
Town Permit No. and/or. CU.D Permit No.
Signed
Lieensed "Drain Layer
The above named;Drain,Layer has a -valid license issued by' the State`of"Connect' cut and
has filed a satisfactory bond an4 insurance. pgli2y ,. , the name of the Town''of S;,.outh;Windsor:
. . _.
Engineering 7Dep rtme t Date
Connection Charge Paid 'Permit Pee: Paid' $ /
Check Number
�. Issued by
GTax a f ice
INSPECTION
Date work 'started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date