HomeMy WebLinkAboutDrain Layers Permit 844 Foster Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT No, 4296
GzvX4,e, 5 19
Pur t to written application, permission is lAreby, grfiiAed,,to t icenSeq Drain Layer
named he to perform, the York in icated below at C �
at prem- owned by 1-
whose "a ress is
Lay for Ho Drain, Repair House Drain, Lay Main, and to
Other
occupancy or use, with
Family its, with acres.
pe of Sewage to be connected under this permit: SANITARY SEWAGE ( ), INDUSTRIAL
WAST ( OR ( ) Connection will be made with
Sh 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.
Signe ..i %��•
dice sed rain 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.4 the name of the To of South Windsor:
Engineering Depart t _ Date
- _
-Connection-eha__rgp_paid - �-d OPermit—Fee:-Paid- -- =J - --- - -- --
i i
'; Che Number
-- - ' 1 ? lJ UQ- Issued- by
(\ Tax Office
INSPECTION
--Date-wark started _
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date