HomeMy WebLinkAboutDrain Layers Permit 62 Evans Crossing TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS,
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT '
�a Ev� C 40SW 19
Pursuant to written application, permission is h e y granted to the Licensed Drain Layer
named herein to. perform the ork indicate&below at;
at premises``•owned by IA - who.6 address is
and'to
Lay House Drain, Repair House 'Drain, Lay Main, Other ,
for occupancy or`"us , raith
Family Units,_: with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ),' INDUSTRIAL
WASTES ( ), OR .{ ) . :Connect'ion will be made with
Show sketch of proposed work or `furnish `two (2) copies of`separate draVings:
r
SPECIAL CONDITIONS
Desired Starting Date Estimated -Tame for .Completion
Permit_ to be issued Ito`
the holder of Drain Layer's License `Permit will expite thfff (3�)"`days
after date of issuance. The undersigned Drain Layer hereby agrees ;to al1 'the terms and
conditions set forth in the permit and the reverse side thereof. AppiicanE`has received
Town Permit No. and/or,),CHD Permit No.
Signed ..
Licensed Drain Layer:-
The above named Drain Layer •has a vialid license issued .h'3'' the State of `Connect cut and
has filed a satisfactory bond and insurance p.oa I `in 'the name. of.'the Towri bf:.:SodA Windsor:
01
Engineering Depart-Met ,Date
Connection Charge Paid °���(�• (} Permit' Fee:' Paid $
F Check Number
eL
Issued by D
Tax Office
INSPECTION
Date work started Date completed
SufficiLidt no i ical=16—n rece ve : Yes No
Special Conditions
APPROVED:
Inspector Date