HomeMy WebLinkAboutDrain Layers Permit 51 Devonshire Drive TOWN OF SOUTH WI N DSOR.
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT O3959
19 d��-
Pursuant to written application, permission is hereby granted to then-Lensed Drain Layer
named herein to perform the work indicated°below at �` _a•_rr3N�lr,,�p. . ,� y,Q
at premises owned by SK -` P fear - -whose address is
and ;to
Lay House Drain, Ke air 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:made with
Show sketch of proposed work or furnish two (2) copies of .separate drawings.
i
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for. Completion
Permit. to be issued to
the holder of Drain.-Layer's.Liceidse No. Permit will expire thirty, '(30) days
after date of issuance. The undersigned Drain-Layer hereby agrees to all the tems 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, ha.yer has a valid license issued by the State of Connecticut and
has filed a satisfactory, bond and insurance policy.-in the named the Town of `South Windsor:
Engineer�epartment Date
Connection Charge Paid 410;0 Permit Fee: Paid $ 00
Check Number
U
�� y oc e- Issued by
Tax fit f ice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:'
Inspector Date