HomeMy WebLinkAboutDrain Layers Permit 35 Garnet Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 3706
Pursuant tp written ap cation, permission is h by grante to the Lic used Drain Layer
named herein to perform t w rk indicated below at w ok, C� 22.�- 'LT 4 st_,...
at premises owned by v cc y-0-. -' whose address is
and to
Lay House Drain, Repair``House Drain, Lay` Main, Other ,
for occupancy or`use, With''
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( , INDTSTAIAL
WASTES ( ), OR ( ) C nnection will be made with
,r
Show sketch of proposed- work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date Estimated Time or Completion
Permit to be issued to Cya
y it will exp re thirty (30) days
the holder of Drain Layer's �L�cense No. Pe
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 hss 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 Soith.Windsor:
Engineering Department, Dates e
Connection Charge Paid Permit Fee: paid $
Check
- Issued by
- Tax--Aff-41a -- --- --- - - - -- - ----
�11.t Q—�
- INSP CTION - -
-
Date work started Date completed
Sufficient notification received: Yes No
--Special-Condit ions
APPROVED:
Inspector Date