HomeMy WebLinkAboutDrain Layers Permit 676 Clark Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 3848
Pursuant to written application, permission is by rante to th Licensed Drain Layer
named herein to perfo t e wo k indi ted bel . at _(o
at premises awned by
;+U whose address is
and to
Lay House Drain, Repair' `Douse Drain, Lay` Main, Other-
for occupancy or'use with
Family Units, with acres.
Type of Sewage to be connected under t 's ppermi�t�• SANITARY SEWAGE , INDUSTRIAL
WASTES ( ), OR ( ) T/ f�,C;.,i, ,Connection will be:made. with
Show sketch of proposed work or furnish two (2) copies 'of'separate drawings.
SPECIAL CONDITIONS
Desired Starting Date EstimatedfTime!f.or Completion a
Permit_ to be issued'-,to
the holder of Drain !,.a s TUense No. Permit will. zre thirty'{30) days
after date of issuance. The undersigned Drams in 'Layer hereby`agrees__to all the terns''and
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No. . -.and/or ;CHD :Permit. No.;
Signed
_ Licensed==Drain;La-y.er
The above named Drain Layer has a valid` .licerise is,sued by- the State` of.Conpecticut and
has filed a satisfactory bond and insurance_policy. i a n of th wn ofySouth:,Windsor:
�P..
J"T A z
- 1
ng , ng Department, Date
Connection Charge Paid$ Je Permit Fee:- Paid
Check Number
Issued by
Ta f f ice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector pate