HomeMy WebLinkAboutDrain Layers Permit 57 Devonshire Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT O 3742
_
Pursuant to written application, permission is hereb granted o the Licensedtain Layer
named herein to. perfo t• e w k i dieat d belo at � �-� y
at premises -owned by :whose :address is
and to-
Lay House Drain, Repair House Drain, Lay' Main, Other ,
for ` occupancy or u.se;- vii
t
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ), INDUSTRIAL
WASTES , Connection will.. be-made with
Show sketch of proposed work-or furnish two (2). copie''s of separate drawings:
SPECIAL CONDITIONS
Desired Starting Date Estimated Time .for. Completion, -,
Permit- to be issued to';
the holder of Drain Layer c,ense No'. Permit will expire,\thirty (30) days
T�a
after date of issuance'. undersigned Drain L yer hereby agrees to all the' texiris and
conditions set forth in the permit and the reverse side thereof. Applicant tas "received
Town Permit No. and/ox :CHD Permit. No.:-
Signed
y Lioensed Drain Layer
The above named.-brain Layer has a valid',license issued W th' State of Connecticut and
has filed a satisfaEtory, bont3 and insurance, policy. in, the name of the 'Town of"::Soutl ;:Windsor:
56
Engineering epartment EDate
Connection Charge Paid `"I"` '��' of 'Permit'-Fee: Paid $
Check Numbery ?
, Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date