HomeMy WebLinkAboutDrain Layers Permit 76 Cheshire Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 3645
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Pursuant to written application, permission is hereby granted o he Lied Drain Layer
named herein to perform the work ndi t:ed below at u� . J(� �',�(Q�, .¢ . , i t*"jGo
at premise`s owaned= by whose- address is
and 'to::.
Lay House Drain, Repair`House' Drain, 1,Lay Maid, Other. ,
for occupancy or:fuse, with,
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (INDUSTRIAL
WASTES ( ), OR ( ) c, Connection will be made with
Show sketch of proposed w,ork• or furnish two (2) copies of separate draw ngs_.
SPECIAL CONDITIONS
Desired Starting Date Estimated•Time for:-Completion
Permit_ to be issued to'
the holder of Drain L yer"'-License No. Permie will expfie 'thirty (30) days
after date of issuance. The undersigned Dra�ayer 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
\ Licehiadd Drain Layer-
ti ..
The above named Drain Layer has 'a valid license issued byy'the State of Connlscticut and
has filed a satisfactory bond. and insurance policy in the name of the Town of So' -```-Windsor:
-29h y- �r-
Engineering:Department," ,Date
Connection Charge Paid Permit`Fees: Paid '$ _o_
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Check Nu er
Issued by
Tax Off's
"
INSPE TION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date