HomeMy WebLinkAboutDrain Layers Permit 15 High Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT ?_ 6
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to-perform the vork ndicat d _below at 16 /
at premise's owned by i y whose address is
. ., and to
Lay House Drain, ein'House' Drain; 'Lay Mani, " Other ,
for occupancy or use, with-
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ), INDUSTRIAL
WASTES ( ), OR O r{ 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. -legit will Aire thirty (34)" 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, Perm; t 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 poli n the on*aa of the Town of, "South;Wind sor:
Engineering Department - -Date _-
Connection Charge Paid D(�''0 Permit 'Fees Paid $
Check N ber
�C d- it Issued by
Tax of 4ce
INS ECTION'
Date work started Date completed
Sufficient notification received: Yes No
_-_Special.-Conditions_
APPROVED.
t Inspector Date