HomeMy WebLinkAboutDrain Layers Permit 11 Bridle Wood Road (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 3894
Pursuant to written application, permission is h ;eby granted t the Licensed Drain Layer
named herein to. perform;the work in=ted1 at '
at premises owned by whose a dress is
and to
Lay House Drain, Repair House' Drain; Lag 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
4
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONSLSc
Desired Starting Date _ Z. Estimated Time or- Comp
letion
Permit, to be issued 'to`
the holder of Drain Layer's`-Licefise No. Permit will expir thirty "(3O) days
after date of issuance. The undersigned Dra�Layer hereby agrees. to ]l the terms, and
conditions set forth in the permit and the reverse side thereof. Applicant has teceived
Town Permit No.. 06' e and/or,CHD Permit No.
Signed
Licensed Drain Layer
The above named Drain Layer has a. Valid 'license issued by'`the Mate 'of 'Conneeticut and
has filed a satisfactory bond and insurance polity iri t e ame' of the Town of. Sdu:t 'Windsor:
g n erin6 Department -'Date
Connection Charge Paid Permit Feet Paid-•$
Check er
Issued
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date