HomeMy WebLinkAboutDrain Layers Permit 54 Garnet Lane �.....s. .... _.. ..:,a _.._ :; . ..-, arc.3•- aFswl ' s_'.Y.
TOWN. Of SOUTH WI NDSO
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT ? 371.5
-19
Pursuant to wri�appon, permission is herby grantedfpo the L ensed Drain Layer
named herein to..perfo he work indicated below at 'c�
at premised owned'by whose address is
:and to.,
Lay House Drain; _ 'Repair House Drain; Lay Main Other ,
for occupancy dr use;- itl
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (`T, INDUSTRIAL
WASTES ( ), OR ( ) - .Connection w ll- be made with
Show sketch of proposed. work' or furnish two (2) copies of separate drawings.'
- r
SPECIAL CONDITIONS
i
Desired Starting• Date Estimated Time for: Completion.
Permit to be i§sued -to
the holder of Drain''Layer's L cen$e No: Permit will expire thirty (30)'days
after date of issuance. The undersigned Sral ayer hereby agrees to allthe 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
Lieensed Drain Layer
The above named Drain Laker has a valid license issued by the State of Connecticut and
has filed a satisfactory bopd and insurance policy in the name of the-Town of Sou h`Windsor:
Engineering Department : _Date
Connection Charge Paid </Op 0 Permit Fee: Pahl
Check NUmber /
,•���YL u e. �: 'Issued by
—Tax---af f:ic - ----- — - - --
INSP CT ON
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions_
APPROVED:
Inspector Date
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