HomeMy WebLinkAboutDrain Layers Permit 1107 Sunfield Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT ,
f
.0 3923-
19
Pursuant to written application, permission is h reby granted 10
th L cen ed Drain Layer
named herein to perform the ork Indic ted belo atzo .
at premises owned by ; .p kd oi,y `_rwJ L whose address is
and 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 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 Layer's .License No. . Permit will expire thirty (30) days
after date of issuance. The undersigned Drain Layer hereby agrees .to all 'the teras'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 Connecticut and
has filed a satisfactory bond and insurance policy in t e name of the Town of South_'Windsor:
Engineering epartment Date
Connection Charge Paid /G�-/r�" 'j . Permit Fee: Paid $ OO
Check Number
!J 1' Issued by
Tax 0 fice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED!
Inspector Date