HomeMy WebLinkAboutDrain Layers Permit 1207 Sunfield Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 9 392.9
19
Pursuant to written application, permission is hereby gr- ted q the icensed Drain Layer
named herein to. per£o ' the work i dica ed belo . at
at premises owned by whase address is
and-to'
Lay House Drain,. Repair House Drain, Lay Main,
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
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Show sketch of proposed work or furnish two (2) copies of separate drawings.
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SPECIAL CONDITIONS
Desired Starting =Date Estimated Time for Completion
Permit, to be issued to
the holder of Drain: Layer's`License NQ. .`' Pet will expire; thirty (30) days
after date of issuance. The undersigned Drain aver hereby agrees to "all the"' term's :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 the name of the_town of, South.Windsor:
Engineering Depart ent Date
Connection Charge Paid ( jq&�L Permit Fee: Paid $ 6 00
Check Number
�11 6,4 10)k hil
Issued by
Tax a rice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date