HomeMy WebLinkAboutDrain Layers Permit 90 Garnet Lane TOWN OF SOUTH W -N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMITNID
_ 3726
CI ate-� . a 1904��-
Pursuant to written application, permission is he/�r�b ranted o the Lic used Drain Layer
named herein to.;perform he work indicated'"below at b�� 36 <f jut �a_tt_P_ y
at premises owned by whose address is
and "to
Lay House Drain, ' epair House Drain, 'Lay Maim, - 'Othet ,
for ' occupancy or use, with
Family Units, with acres.
j
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( , INDUSTRIAL
WASTES ( ), OR Qonnec on ill 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 Drain Layer here by "agrees to al the terms.and
conditions set forth in the permit and ,the.reverse side thereof`. Applicant la.s received
Town Permit No. and/or CHD Permit No.
Signed
Licensed Drain 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 in the name of` the `town bf Sout"h.Windsor:
/9
Engineering Department Date
Connection Charge Paid Permit Fee: Paid $ /5,LO
Check Njm6er, Q l6
Issued by
ita
INSP CTION 77
Date work started Date completed
Sufficient notification received:. Yes No
- -Special-Conditions .
APPROVED:
Inspector Date
1)