HomeMy WebLinkAboutDrain Layers Permit 0571 Avery Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT � 38tR
Pursuant to written application, permission is hereby granted to a Licensed Drain Layer
named herein to-perform the work indicat ddbelpw at
at premises-owned by A14 L ti. w ose.address is
V. 8 _to:
Lay House Drain,- Re�ilr- House` Drain, Lay Main, Other ,
for
occupancy or, use, with j.
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 Laygr's:.License No. " Permit will expire thirty '(3'Q)'1days
after date of issuance. The undersigned Drain Layer Hereby agtees' tb all •the t61,4 6 ,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 issued by the State of'Connertcut and
has filed a satisfactory bond and insurance,.policy. in the alma of; the Town of rSoutti'Windsor:
Efilfineeeiag Departmexit. ��' -D to
Connection Charge Pad -Permit Veec` Paid
x
Check Number 3
Issued by
A4_'TLa'x_6tfice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date