HomeMy WebLinkAboutDrain Layers Permit 834 Foster Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT ®
® a
'93 FpS 5� . 2 , 19 �S
Pursuant to written application, permission is her gar nted t
named herein to perform thr �C in Gated below a 9 Lice sed Drain Layer
at premises owned by
whose address is
Lay House Drain, Repair House Drain, La Main and to
for y , Other ,,
Family Units, with acres. occupancy 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 drawings.
SPECIAL CONDITIONS
Desired Starting Date Estimated.
Time for Completion
--------------
Permit_ to be issued to
the holder of Drain Layer's License No. Permit will expire thirty (30) da s
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 the name of the Town of South Windsor:
Engineering Department Date
Connection rge Paid �- permit Fee: Paid - !� /
y
Check Number.
Issued by01
Tax affice
INSPECTION
Date work started Rate.completed -
-- U- iczen -nofi-fication received: Yes
No
Special Conditions
APPROVED:
Inspector Date