HomeMy WebLinkAboutDrain Layers Permit 152 Debbie Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT No4946
19 0 b
152 �bbi� �✓L
Pursuant to written application, permission is hereb , granted t the Lic sed Drain Layer
named herein to. perfor�mthe work indicated slow at
at premises owned .by perform the
�. d eyl (-,': whose address is
and to
Lay House Drain, Repair House Drain, 'Lay Main, Other ,
for occupancy or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ), INDUSTRIAL
WASTES ( ), OR ( ) Connection will be spade with
f _ i
f 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'sAicense No. Permit will expire thirty (3D) 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 Na. and/or, CHD Permit No.
Signed
Licensed Drain Layer
The above named Drain Layer ha;s, a valid license issued by the State,.'of 'Connecticut and
has filed a satisfactory bond and insurance policy in'the name of. the Town of Sout+l ,.Windsor:
Engneering-.Department Date
Connection Charge Paid 6j Permit Fee: Paid
Check Number
Issued by
Tax Otfise
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date