HomeMy WebLinkAboutDrain Layers Permit 90 Foster Road (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT f 4�
19S
Pursuant to written application, permission is he ebV nt d t the icensed Drain Layer
named herein to-perform. h work in cated b low at (}
DA
at premise's owned= by whose address is
and to
Lay House Drain, Repair House Drain, `Lay-Main, Other
for occupancy or`�}se, with
Family Units, with acres.
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
'j
i
SPECIAL CONDITIONS
Desired Starting Date - Estimated Time :for Completion
Permit- to be issued,'to
the holder of Drain Layer's .Vic:ense No:: Permit will expire''thirty (30), days
after date of issuance. The undersigne 15rain Layer hereby agree"s `"to all the terms and
conditions set forth in the permit and the reverse side there- Applicant has received
Town Permit No,. , ,,:,and/or CHD Permit No.
Signed
The above named: Prain Layer has a valid license issued b� the State:' nneeticut and
has filed a satisfactory bond- and insurance policy'.,in t]ie n, of'Ae the Town oi; South"Windsor:
Engineering-,Department.. Date
____Connection- Cha a Paid
Check Number
Issued by - _ -
Ta Office - -- - -
INSPECTION
- - Date--work started _ _
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector pate