HomeMy WebLinkAboutDrain Layers Permit 402 Spring Meadow Dr TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 3830
1
Pursuant to written application, permission is h eby Mrted o the Licensed Drain Layer,n
named herein to perfoxa the w rk i dicate below at A)CAPAJOW
at premises owned by whose:address is
- and to
Lay House Drain, ` Repair House Drain, Lay'Main; Other ,
for ---r-'—
bccupancy or use, with'
Family Units, with acres:
Type of Sewage to be connected under this permit: SANITARY SEWACE ( ), INDUSTRIAL
WASTES ( ), OR_ ( ) Connection will .be made with
Show sketch of pzoposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS j
Desired Starting'Date Estimated-Time for :Completion
Permit_ to be issued ,to'
the holder of Drain Layer's ,License,'No. , Permit will expire thirty' ( 0) days
8 =---,-'
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;9HD Permit No.
Signed
Licensed Drain'Layer
The above named Drain Layer' as 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:
Engine g: epartment Da e
Connection Charge Paid —hf t�5 �c Permit Fed;' Paid` $ `
Check Number1_O
AL 4,: Issued by.
Tax O fice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date