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HomeMy WebLinkAboutDrain Layers Permit 61 Debbie Drive TOWN OF SOUTH Wt N DSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT .k�M��_ 2 r1 1 ,7 19 Pursuant to written application, permission is hereb gran ed the 'ceased Drain Layer named herein to perform he work- ind aged : low at, at premises owned 'by € dtv - whose-::address is and t© Lay House Drain, Repair Houee` Drain, Lay "Main, Otler , for occupancy or use; raitti'` 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 pjcoposed work or furnish two (2) copies of separate drawings'. SPECIAL CONDITIONS Desired Start ng'Date . Estimated Time for:Completion Permit to be issued°to - { . the holder of Drain Layer's License No.. _. Permit Will expire €hifty (319Ydays after date of issuance. The undersigned Drain Layer lier'eby'agtees `to all the`*teXis_,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 Layetc The above named. brain Layer has a valid license`}issued by the State of Conhec-icut and has filed a satisfactory bond and insurance, p.a' x. in ;the name of the,Tobin of'.So.Uth'Windsor: 304 Engineering,'Department -Date Connection Charge Paid �Yl .� - Permit Fee: Paid $ r Check Numbers Issued by • . Tax Office INSPECTION Date work started Date completed Sufficient notification received: Yes No Special Conditions APPROVED: Inspector pate