HomeMy WebLinkAboutDrain Layers Permit 21 Devonshire Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 3741
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Pursuant to written application, permission is ereby gran ed to the Licen ed Drain Layer
named herein to. perfo ' �e worNndi atad elow-.at �,
at premises owned by C 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 O, OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS -
Desired Start hg! Date Estimated Time for Completion
Permit- to be issued to
the holder of Drain Layer's -License No'. Permit will expire thirty (30)" days
after date- of issuance. The undersigned Drain Layer hereby agrees to all the"ternis_.and
conditions set forth in the permit and the reverse side thereof. Applicant has' rec'eived
Town Permit No.. and:/or CHD Permit No. ,
Signed
Lieensed Drain Layer
The above named .Draln Layer has 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"South"Windsor:
e5
Engineering Departm nt Date
Connection Charge Paid Permit Fee: Paid $ 1 b
Check Number
. V Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date