HomeMy WebLinkAboutDrain Layers Permit 35 Devonshire Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
AI Iw-",& , 199-T
Pursuant to writtenapplication, permission is h reb grante to a Licensed Rra�n Layer
named herein to erfo he wo�• indicated�"b low: at ,l a r�� „p
at premises owned by �(. =l .8~A C�/',N�C� whose-.address is
and to--
Lay House Drain,-', Repair` ouse 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 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 igstied :to
the holder of Drain Layer's"License No.. Permit will .ekpire thirty (30) "days
after date of issuance. The: undersigned rain"Layer hereby agrees 'to all the-'.te us' and
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit Na: and/or CHD:_Perm t- No.
1; signed
Licensed Drain. Layer
The above named Drain Layer has a valid; lice nse 'issued by the State of Conn etticut and
has filed a satisfactory; bond, and ;npsurance policy:in the name of th'e_ Town 'of:$outi "Windsor:
A 13 )i
- Engineering Department: ,.. .Date
Connection Charge Paid(-646-pt7 / Permit Fees Paid $ (�
Check Number
Issued by ,
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date