HomeMy WebLinkAboutDrain Layers Permit 305 Spring Meadow Dr r-',...
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TOWN OF SOUTH Wt N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT ? 37
190�
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform the work indicated below<at> e;�, .
at premises `owned by • 5a whose address is
and to--;,
Lay House Drain, Repair` House`"Drain, _ Lay Main, — Other ,
for cSecupancy or use;, with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE I INDUSTRIAL
WASTES ( ), OR ( ) � Connectiion will be;made with
Show sketch of proposed work 'or furnish two (2) copies of separate drawings
SPECIAL CONDITIONS f
Desired Starting Date Estimated Time for Completion
Permit- to be issued%to
the holder of Dr'ain `Layer's License NQ.. ' _,' Permit will expire thirty
('30 ;days
after date of issuance. The undersigned Drain Layer �iereby agreps, to .all the"ternt's and
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No. and/or CHD Permit Na.:_ a • ; ,
Signed afi
A iconsed Draia:,Loyer
The above named. Drain Layer has' a valid '1 icense issued by the "State: of`Cvntiect cut and
has filed a satisfactory bond and insurance policy 'in 'the `name, of''the �'owii off.Soutli Windsor:
Engineering,-Department A)ate
Connection Charge Paid I rd� ��.. Permit Pee: Ps.•id $ , 0
Check ber
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date