HomeMy WebLinkAboutDrain Layers Permit 110 Dart Hill Road (2) R TOWN OF SOUTH WINDSOR
i DEPARTMENT OF PUBLIC WORKS
�. BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT N0 4248
19 C �p
Pursuant to written application, permission is hpreb� gra ted to Ahe Lic sed Drain Layer
named herein to perform he work i dicat be ow at. ] �,� ��� �� ���
at premises owned by
whose address is
Lay House Drain, Repair House Drain, and to
for Lay Main, Other ,
Family Units, with acres. occupancy or use, with
Type of Sewage to be connected under this permit: SANITARY SEWAGE (A" INDUSTRIAL
WASTES ( ), OR ( )
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
1T 4
p �� 6" Pt✓c t-1 rJ,F
h/AV
SPECIAL CONDITIONS NCI- L ?J3
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No. �#,,7 Permit will expirethirty (30) days
after date of issuance. The undersigned Drain Layer 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
-� Lic�ens Drain
The above named Drain Layer has a valid license issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy i name of the Town-vof South Windsor:
. Engineering Department Date
Connection Charge Paid b_" . 6
(�IQ � Q� Permit Fee: Paid $ 0
Check Number ��
Issued by
Tax I fice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Harp