HomeMy WebLinkAboutDrain Layers Permit 108 Cheshire Drive TOWN OF SOUTH Wt N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT Q�3686
19&)—
Pursuant to written application, permission is hereby gra ted to theLicenged Drain Layer
named herein to perform the ork indicatedw. ':belo at b ! 0
at premises owned by whose address is
and to
Lay House Drain, Repair House Drain, Lay Main, "` Other ,
for T— "occupancy or use,, �iitY
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ), INDUSTRIAL
WASTES ( ), OR ( ) Connection will 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 s:
the holder of Drain Layer's License No. Permit will expire thirty (�'0') days
after date of issuance. The undersigned Drain Layer Hereby. agre' es to all tte'te and
conditions set forth in the permit and the reverse side thereof. Applicant ha''s received
Town Permit No. and/or CHD Permit No.
Signed
Licensed Drain Layer,
s
The.above named Drain Layer has ,a valid license7issued' by the State of Connecticut and
has filed a satisfactory bond, and insurance policy n e �of �he Town of South Windsor:
7- 1 �
d�� q Engineering Departib6nt Date
Connection Charge Paid O0 . d Q $ f IR Permit Fee': Paid
Check Number
Issued 'bq
Tax office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date