HomeMy WebLinkAboutDrain Layers Permit 1311 Sunfield Drive -. `',t. .' ... •.is r '... '-.. ... .
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL i
DRAIN'LAYER'S PERMIT 4039
'I
Pursuant to written application, permission is h reb gipnted" to the L censed Drain Layer
named herein to perfoyp the worISind'cat:ed elow at
at premises• owned by whose address is
and to
LayHouse Drain, Repair'Hous� '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 o.r 'furnish two (2) copies of separate "drawings:
SPECIAL CONDITIONS
Desired Starting Date - Estimated Time for iCompletion.
Permit_ to be iss6e'd 'to
the holder of Drai4,'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 Lay:er''has a valid license issued by, the 'State' of Connecticut and
has filed a satisfactory bond, and insurance policy. in the natge of 'the�Towwn of South Windsor:
Engineering Department,-. ,. -:Date
Connection Charge Paid 8 Ab / Permit Veei Paid
}O
Check Number
la"t ..._.__.. Issued by ,
Tax 6ffice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions ;,
APPROVED:
Inspector pate