HomeMy WebLinkAboutDrain Layers Permit 15 Garnet Lane ;. .
TOWN OF; SOUTH WINOSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 395
19 d
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Pursuant to written application, permission is hereby grant to the Li ensed Drain Layer
named herein to. perfo he ork indicated below atm
at premises owned, by a whose address is
and to
Lay House DrAin Repatir 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 { ), INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
j.
SPECIAL CONDITIONS 1
Desired StartingDAte Estimated Time for Completion.;
Permit to be issued to
the holder of Drain Laygr's license No: Permit will expire thirty (30)-days
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 has' a.valid license issued by the `State. of Connecticut and
has filed a satisfactory bond and insurance policy in he name of the Town of'$ouh Windsor:
Engineering Department Date
Connection Charge Paid . (, D Permit Pee: Paid
Ch k Number
Issued b _:.
y
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INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special- Conditions
APPROVED:
Inspector Date