HomeMy WebLinkAboutDrain Layers Permit 45 Carson Way TOWN OF SOUTH WI N DSOR
e DEPARTMENT OF PUBLIC WORKS
€ BUREAU OF POLLUTION CONTROL
N2 5 911
DRAIN LAYER'S PERMIT
. a 2 19
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Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named h""rein to perform the work iAdi.c ed below t
at premises owned
whose address is , Art,' viand to
Lay House -DraAfn,�,� se Drain, La Ml, Other
with
Family Units, /fth _ � acres.
Type of Sewage to be �n�r�r��d under
C s permit : SANITARY SEWAGE (►') . '>
INDUSTRIAL WASTES ( );" OR +
Connection: will be made, with
Show sketch of proposed work or furnish 'two (2) c i_ s of separate drawings.
OSHA REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to jp - . .�,{. .
the holder of -Drain Layer's Lice set o.
(30) days after date of issuance. he undersigned Wain L yer hereby agrees
to all the terms and conditions set . forth in the permit and the reverse side
thereof . Applicant has .received Town Permit No. SJ�// and/or
CHD Permit No.
Signed
icens d rai Layer
The above named Drain Layer has a valid �/icense ssue by the, a,.te. o
Connecticut and has filed a satisfactory bond and insurance policy;'in`the �Y
name of the Town of South Windsor: rf
lumber
g neering Dept. Date
Permit Fee Paid $ ?� . Cheek \\
Connection Charge Receipt No.
Lsaued by4
INSPECTION
Date work started r g Date completed
Sufficient notif ica on—reecce ve : Yes No
Special Conditions
APPROVED•
Inspector Date