HomeMy WebLinkAboutDrain Layers Permit 108 Debbie Drive 77
TOWN OF SOUTH ` WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
Pursuant to written application, permission is h r by grant d to the L•ce ed D in Layer
named herein to '-Perform-the workn�&ate&..4elow,�at-,
at premises owned by ._ =twt ose:_ ddxess is
t,
Lay House lYrain, et use Drain,.- Lay'Ma ;` 0tlFe ,
for occupan2V 'qY'qee, with'
Family Units, with acres':
Type of Sewage to be connected under this permit. SANITARY SEWAGE ( ),' INDUSTRIAL
WASTES , Cannec; - o� w1� 1.;_be,.made.,with
Show sketch of `proposed wark `or furnidh `two (2°) copies 'if se `arat'e t- awin` s
SPECIAL CONDITIONS 3.r'
Desired Start=figrDefe :EstimatddTime >for.,4C-Amplet3on
Permit, to be `issued 'te _. ..
the holder of brain `Layer's license" Nam Pertitit `w .11 expzre thirty (SQ 'days
after date of issuance. ' The undersigned Drain Layer hereby ag•'rees to a21 ytYi2`te-rmgr,and
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No=� _. andjQr=:;GRID -Permit No .,_ :> r,
- �•La.sed,.�rafin�:&'ay-e�:
The above named, Dr4ih L1ayer has; a valid licens'.s a§sf�ec by;'t f'e st4te of, o`nnVcticut and
has filed a satisfactory bind end insurai � p�li�y ;i tie jam jy. ttie To'wri Hof 'S�outl.�"Windsor:
-tit
Eixgineerim7 -,Dc pab-t�menb. s Date
Connection Charge Paid
Check Number
-. -. f
ls`euet'k by
Tax Office a
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date