HomeMy WebLinkAboutDrain Layers Permit 7 Debbie Drive TOWN OF SOUTH WI NDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 4992
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to. perfo the work in Gated below
:at ,' /, / Z, l
at premises owned by a /'iv - ;.; whose address is
and to.
Lay House rain,' Repair House' Drain,` Lay Main,' Other ,
for occupanty or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE O, INDUSTRIAL
WASTES ( ), OR { ) Connection w ll. 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
the holder of Drain Layer's License;No. Permit will expire thirty '(30)• days
after date of issuance. The undersigned Drain Layer herebyagrees 'to 'aXI th6-terms and
conditions set forth in the permit and the reverse side thereof. Applicant has"`teceived
Town Permit No and/or,:CHD ;Permit No. ,
Signed
>Licensed brain,Layer.
The above named Drain Layer has a valid license 'issued. by"the State of 'CanrieCticut and
has filed a satis4aetory, bond and insuraxine policy n ,the name of the Town bf, South`,Windsor:
L Engineering Department, Date
Connection Charge Paid ( , Permit Fee: Paid $ /�* V
Check Number �-
LC Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date