HomeMy WebLinkAboutDrain Layers Permit 15 Devonshire Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT ? 3762
Pursuant to written application, permission is h reb g anted to the Licens d- Drain Layer
named herein to. perfo th wor isd eated�below , t. ,,;, zi U4 .Jz�_.:. Y;
at premises''owned by e. � r whose address is
_ -,and: to
Lay House Drain', `' Repaiz` 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 ( )s OR Connection will. be:made with
Show sketch of proposed work .or furnish `two (2) copies of separate "$rawings�i
SPECIAL CONDITIONS
Desired Starting -.Date Estimated -Time for Completion ..:•"..
Permit_ to.be issued 'to`
the holder of Drain, Layer' -Vicense'No. }` "Permit'`will expire-'thrr'ty (SO days
after date of issuance. The undersigned Drain Lay er hereby agrees :to ',a11 '1. the' t6rms',`and
conditions set forth in the permit and the reverse side thereof. '`Applican.t'has rem .ceived
Town Permit No. and/ow.,GHD::Permit. No.
XS
.. .,_ .. igned _
z_ Licensed. Drain Layer
The above named 1� a3�n Layer'has: a valid: license issued' by' the'•State"of Connecticut and
has filed a satisfactory bond axed .insurance poI cy, in the n//a��me .pf; the Town-9f; SoutA"Windsor:
Engineering epast ent, Hate
Te
Connection Charge Paid �a 8' � "'Permit;Fee:, Paid $ Q
Check Number
Issued liy
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date