HomeMy WebLinkAboutDrain Layers Permit 505 Spring Meadow Dr TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER S PERMIT 3769
1�t Ila 19C
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Pursuant to written application, permission is 45reby granted to the Licenqqd Dra n Layer
named herein to. perfo the ��w�pr-k ndicat. d below a
WL' `
at premises owned by ` ( A. 410 S'0(�,( o ose:;address is
and to ._,
Lay House Drain, Repair-House Drain, Lay Main, Other ,
for occupancy or ,use,` with.;
Family Units, with acres:
Type of Sewage to be connected under this permit: SANITARY SEWAGE X, INDUSTRIAL
WASTES ( ), OR -( ) Connection �Oi11.-be. made with
Show sketch of proposed work or furnish two (2) copies of separate drawings,:
SPECIAL CONDITIONS
Desired Starting Date ` ` Estimated Time for Completion
Permit- to be issued to'
the holder of Drain Layer's`License No. Permitlwil expire th±,,fty (30)' days
after date of issuance. ' The undersigned Orarhayer hereby'agrees_ to 'all the 'tdbfis' and
conditions set forth in the permit and the reverse side thereof. Applicant has-'received
Town Permit No. and/or;,CHD Permit, No.
Signed
Licensedt.Drain Layer
The above named Drain ,Layer has a valid license issued by the State' of Conhect'icut and
has filed a satisfactory bond and insurance policy iA ' e name ot;'the',Town'`of` South;Windsor:
- �- g
n neeri Depa tment .rDate
Connection Charge Paid �' ' � Perniit Fee: Paid $ I (3
` _
Check Y17ber
r
Issued by
Tax Office
INSPECTION_
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date