HomeMy WebLinkAboutDrain Layers Permit Lot 46 Darlene Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL ��TT
DRAIN LAYER'S PERMIT 1T�. 4 3 9 9
196�
Pursuant to written application, permission is hereby ranted to the Lice sed Drain Layer
named herein to performthe work indicated belo at
at premises owned by whose 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 ( ), INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
_ ,CSSiC,A
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No. ermit will expire thirty (30) days
after date of issuance. The undersigned 5iiiin Layer hereby agrees to all the terms and
conditions set forth in the permit and the reverse side thereof. A icant has received
Town Permit No. and/or CHD Permit No.
Signed
L' ense DDrain L r
The above named Drain Layer has a valid license issued by the State of Connecticut and
has filed a satisfactory bond and insurance poW
the( a of the Town of South Windsor:
9_ L� 2e,
ngineering Depart nt a e
7
Connection Charge Paid (fCf Permit Fee: Paid $
Check r/�
Issued by L "
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date