HomeMy WebLinkAboutDrain Layers Permit 1208 Sunfield Drive T IR
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT _-_,
Pursuant to written application, permission is hereby' gr me tot Licensed Drain Layer
named herein to. perform he work indicat.ed :b low at _.
at premises owned,by 411tAp.4 0 whose address is
and to
Lay House Drain, Repair. House Drain, 'tay 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 O Connection will.-be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Start-ig 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 terms 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 vali� 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 Department Date
Connection Charge Paid 119 L/ d II Permit Fee: Pdid° (�
Check Number
-Qr-r"' Issued by
"TaxOffice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date