HomeMy WebLinkAboutDrain Layers Permit 16 Devonshire Drive TOWN OF' SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 3744
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Pursuant to written application, permission is h reby gr n e to the Licensed Drain Layer
named herein to ,perfo the or in .scat belo at
at premises gowned by �' j ., whose address is
and to
Lay House Draii•►-, - Repaif"Rouse' 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
i
Desired Starting Date4• Estimated Time for Completion-
Permit_ to be issixed to
the holder of Drain'Layer.',slicerise No.. Permii' will expire thi"rty (30)"days
after date of issuance The undersigned Drain Layer hereby agrees,,to all the terms and
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No.. _and/or CHD .Permit No.
Signed
Licensed Drain Layer.:
The above named Drain Layer has a ,valid license `issued by,the 'State, of Connecticut and
has filed a satisfactory bond; and insurance policy _in..th`e name.of. the Town of 'South;Windsor:
Engineering 11epairtment s •,Date
Connection Charge Paid g �`(�•-�� y� Permit Fee- laid
Check Number
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector pate