HomeMy WebLinkAboutDrain Layers Permit 14 Jared Court TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT ''N'O 5828
Pursuant to written application, permission i - hereby granted to the
Licensed Drain Lay, r e erein to perform the work indicated below at,.
at p e i wne by
w os a dress is
�i�► s�t>.' . and to
Lay Hou r n, Repair o -s'e Drain, Lay Main, , Oth r ,
for occupancy or use, with
Family Units, ith WVacres.
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.
SPACIAL--CONDITIONS
<- S
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 hereby agrees
to all the terms and conditions set forth i. sthe p em it a d the reverse side
n thereof. Applicant has, received Town'_ No. � s and/or..
CHD Permit No. -
Signed
Licen ed Layer
The above named Drain Layer has a valid license i4s. edby the State of
Connecticut and has filed a satisfacto y bond and insurance policy in, the
name of the Town of South Windsor':
ng n ering Dept. Date
Permit Fee Paid Ch c Number
Connection Charge Receipt No. Dated
Issued by
INSPECTION
Date work started Date completed
Sufficient notif is-a on receiv- a ." es No
Special Conditions
Inspector Date