HomeMy WebLinkAboutDrain Layers Permit 10 Devonshire Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 3745
Pursuant to written- application, permission is ere y ranted to th cerise Drain Layer
named herein to perfo die or ind'cat.ed below:- t >
at premises ,owned by C whose<address is
,..
and to,
Lay House Drain, Repair House' Diain, "Lay''Main, Other" ,
for T dccupsncy or`.use, with`
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWACE ( ), INDUSTRIAL
WASTES ( ), OR ( ) ;,Connection will be,made with
Show sketch of proposed work br furnish e*o `(2)• copies of separatedraw:n
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain `Layer's License No. Peii lt'.will expire 'thirty (30)- days
after date of issuance. The undersigned Drain Layer hereby agrees `to� all' t
he` term4 and
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No.= -and/or C.DD Permit No.
Signed
titensed Drain Layer.. .
The above named Frain layer has A valid licensd issued by the gtati of Connea 'icut and
has filed a satisfactory bond and insurance pol cy. In the ame of, the;Town`of` South Windsor:
Engine ring : epa merit,, Date
Connection Charge Paid ' - Permit Fees Paid
Check Number
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date