HomeMy WebLinkAboutDrain Layers Permit 32 Bridle Wood Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT Q 16.5
19 kz
Pursuant to written application, permission is hereby granted to the Licensed Drain
named herein to perform the work indicated below at. / j
at premises owned by whose address is
sand .to
Lay House Drain, Repair-'`House 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 fu riiisi ?�) c es of se crate drawings.
If
SPECIAL,CONDITIONS
Desired Start ng Date Estimated Time .for-Completion
Permit- to be ssued'to
the holder of Drai -Layer's'-Li.eenseiNo. ' Permit will expire thirty (30)' days
after date of issuance. The undersigned Drain Layer hereby agrees 'to"all 'the tdiis and
conditions set :forth in the permit and the reverse side thereof. Applicant 'has received
Town Permit No. :, and/or: CHD_-Permit No. d
Sig
Uc`ff9&r, r in Layer
The above named Dran .ayez bas a valid 13cnse issued by the 'State; of Connecticut and
has filed a satisfactory bond and insurance poady i name " f the wri bf South`Windsor:
h
Fmgineerin epari a .Date
Connection Chaff Paid' :L �' L Permit Fee: Paid $ S
C),
Check Number
Issued by .
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector pate