HomeMy WebLinkAboutDrain Layers Permit 1302 Sunfield Drive -y..
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT Wo 4932._
19�
Pursuant to written application, permission is hereby- gr ted to th Licensed Drain Layer
named herein to .perform"the work in icate/ -below-,at
at premises owned by- 7�aS� 8 whosef:address is
- and to
Lay House Drain, Repeii"House Drain, Lay Mani, 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. y
SPECIAL CONDITIONS
Desired Starting Date Estimated .Time for Completion
Permit_ to be issued to ;
the holder of Drairi Layer's`-I;icense No. Permit will expirethirty (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, gain Layer has a valid license issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name the " wn`"of "Soudi'Windsor:
Engineering"Depart ent ,.Date
Connection Charge Paid' 1 k " Permit Fee: Paid"
Check Number ""�_
/- Issued by
Tax affice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date