HomeMy WebLinkAboutDrain Layers Permit 78 Garnet Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT X? 372.5�
Pursuant to written application, permission is he M
granted o the ice ed Drain Layer
named herein to perfo he work indicated.-below.-at �` 3,`J+.;: G`,�3't�': 1+�
j at premised' o n dd ,by, lZ whose:address Ts
and to
Lay House Drain, ' Repair"'huse 'Drain, 'Lay'Main, Other ,
for -� occupancy 'b* u' ser 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
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) days
after date of issuance. The undersigned rain 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 bag at 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 Charge Paid Y -0 E Permit Fee: Paid
Check Nu U
Issued by
Tax-offi
L� u�--
INSP CTION
"T
Date work started Date completed
Sufficient notification received: Yes No
_Special--Conditions
APPROVED:
Inspector Date