HomeMy WebLinkAboutDrain Layers Permit 343 Dart Hill Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 3636
y_/J , 19 db—
Pursuant to written application, permission is here3,Y3' grant-A to the Licensed Drain Layer
named herein to perform the work indicated-below at *3+3
at premises owned by whose.address is
- and to
Lay House Drain, ' Repair-`House `Drain Lay Main, Other ,
for ——�---r—
occupancy or.use, with'
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWACE` ,( INDUSTRIAL
WASTES O, OR O Connection will be.made with
('
Show sketch of proposed work or furnish two (2) `ebpies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit- to be issued to -
the holder of Drain Layer's ,License No.- Permit will expire thirty' (30) days
after date of issuance. The undersigned Drain yer hereby agrees to a1:1"the terms and
conditions set forth in the permit and the reverse side thereof. Applicant has 'r-ce'ived
Town Permit No.- and/or -CHD -Permit, No.
, •: Signed
Licensed Drain liayer
The above named Drain Layer has a vaalfd.license issued b'r the State of Connecticut and
has filed a satisfactory bond and insurance policy 'in the namo of"the Town of' South Windsor:
Engineering Department Date
Connection Charge Paid Permit 'Fee: Paid ,$
Check ber � ,6
Issued by
TaMice
I SPECTION
Date work started Date competed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date
1