HomeMy WebLinkAboutDrain Layers Permit 24 Avonwood Drive TOWN OF SOUTH W1 N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROLZy.
DRAIN LAYER'S PERMIT 63 -
Pursuant to written application, permission is ere y g ante to the Licensed Drain Layer
named herein to.:perfo th w rk 'ndi aced .below at p f '11 D,%1(,(� r'
at premises owned.,by , � � - whose address is
and;to
Lay House Drain`, Repair House
for 'Drain, Lay' Fain, Other ,
_. _ ._ — ,-.
accupancy or `use; ith
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE. ( ), INDUSTRIAL
WASTES ( ), OR- ( ) Connection wiL1,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 Dr'-,a- Layer's License No. Permit wil expire-�thifi (3Of)''-`days
—•,
after date of issuance. The undersigned Drain Layer hereby agrees to all the'te�ms,;and
conditions set forth in the permit and the reverse side thereof. 'Appl16anthas"`re6eived
Town Permit No, and/or: CHD.Permit. No.
r F
. Signed
Lioensed'Drain. Layet�
The above named Drain. Layer has,. a valid license issued by the`State; of Connec#cut and
has filed a satisfactory. bond and insurance policy,in,.the name of the flown of, $outfit'Windsor:
; Engineering epartm nt Date
1 cJ
Connection Charge Paid qY)d,d o d d 15 permit Fee: Paid'$ A
16
a�
Check Number
Issued by .
Tax Office , ,
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
\ Inspector pate