HomeMy WebLinkAboutDrain Layers Permit 1605 Arthur Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
' l�J
Pursuant to written application, permission is herfeby bra ed o the icensed Drain Layer
named herein to -performhe or ndi a :ed-below<at f t1
at premises owned,by whose address is
Lay House in, Repair Hous and to
e Drain, `Lay Main, Other
for 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 ttw (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 thifty (30)-days
after date of issuance. The undersigned Dra— in 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 issue$ by theFState of Connecticut and
has filed a satisfactory bond and insurance policy the name. of 'the Town of Sou
Windsor:
Engineering Depart nt Date
Connection Charge Paid Permit Fee: Paid $ �`
Check Number
V Issued by
Tax Of ice r,
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date