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HomeMy WebLinkAboutDrain Layers Permit 200 Debbie Drive ."' TOWN OF SOUTH WINDSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL iDRAIN'LAYER'S PERMIT © ! 4396 Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below a at premises owned b =' V. whose address is House Drain, Repair House Drain., La Main and to Y , Other Fainily Units, with acres. occupancy or use, with J Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ), INDUSTRIAL WASTES { ), OR ( ) Connection will be made with Show sketch of proposed wor u•� -s4r-tp 2) copies of separate drawings. ice, fit r � Sal-, SPECIAL CONDITIONS - Desired Starting Date Estimated Time for Completign - Permit to be issued to the holder of Drain Layer's License Permit will expire thirty M) days after date of issuance. The undersigned Drain Layer hereby agrees to all the terms d conditions set forth in the permit and the reverse side thereofX�Applicant has rack ved Town Permit No. and/or CHD Permit No. �/ Signed / AI icensed Dra' Oyer The above named Drain Layer has a valid license issue?/ the State of Connecticut and icyf? has filed a satisfactory bond and insurance pol x �the name of the Town of South Windsor ngineering Department Date ' Connection Charge Paid ;,'� , Permit Fee: Paid $ JrJ Check Number (A x- Issued by Tax Office INSPECTION / Date work started Date completed Sufficient notification received: Yes No Special Conditions APPROVED: 1-- Inspector ^` Date