HomeMy WebLinkAboutDrain Layers Permit 360 Felt Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC_ WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT a 53
y .
19 fir,
Pursuant to written application, perMission is hereby gr_anted_ to�he Licensed Drain Layer
named herein to 'perform the work indicated below at «{.�
at premises owned by whose address is
and to
Lay House Drain, Repair House Drain, _ T 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
v,
Show sketch of proposed@uyork�or furnish two (2) copies of separa a drawings t
SPECIAL CONDITIONS
Desired Starting Date Esti aced Time for Completion
Permit to be issued to 60L1-4 OLl
the holder of Drain Layer's License No. c}0 1-? Permit will expire thirty (30) days
after date of issuance. The undersigned Drain Layer hereby ag ees to 11 the terms and
conditions set forth in the permit and the reverse side there p scant has received
Town Permit No. and/or CHD Permit No.
Signed
Li�ense_d.-1P- ain Layer
The above named Drain Layer'°has a valid license issued by th tate of Connecticut and
has filed a satisfacto bond ry and insurance policy i th name of the To of South Windsor:
Engineering epartment Date
a7
Connection Charge Paid w /r c�y Permit Fee: Paid
Check Number
Issued by
Tax Office_ -
INS?ECTION
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Sufficient notification received: - s iDate completed
No
Special Conditionsse
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APPROVED:
-rnipdctor rDate'
Construction Inspect Ion Report
Developer
Work in Progr�s
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