HomeMy WebLinkAboutDrain Layers Permit 50 Evans Crossing TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
50 OiJQM C40zsIng , 19
Pursuant to written application, permission is hereb ranted o the Lic used Drain Layer
named herein to. perform tb@ work indicated below at �j
at premises�dwned by (�� v
-whdse addr s is
La House Drain and-to
y "Repair, Drain, Lay Main, Other
for - s
Family Units, with acres occupaney or use, with
.
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 drawing's.
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for. Completion .
Permit, to be issued''`to
the holder of Drain ` ayer'..s License Nq. wit
zt+8 Permit will expire `thirty (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:.CID •Permit No.
Signed
-Lieensed Dran: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 the name of the Town of *South Windsor:
Engineering Departme t
Date
Connection Charge Paid _ O� . U ' Permit Fee: Paid $ �d `.
Check Number L
�ZL Is"sued by
Tax Office
INSPECTION
Date work started Date completed—_ _._—_—__�___
SUffidlentno 1 scat on received: Yes No
Special Conditions
APPROVED:
Inspector Date