HomeMy WebLinkAboutDrain Layers Permit 41 Jessica Drive . '�'`, . , s m i•.r� +.sY.�.a x.� ._ i.. r :c�. j. .� .egw:i�� .a-, �3 },T ;'s'
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL �7 DRAIN LAYER'S PERMIT o, 45 45
19 i
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Pursuant to written application, permission is hereby grant d to the Licensed Drain Layer
named herein to. perform the work ind�'cjted Wow at (. �9
at premises owned by ,�; � whose address is
and to
Lay House Drain, Repair 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.
t
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No. Permit3will-expire thirty (30) days
I A"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
The above named Drain Layer has a valid license issued by the State of'Comecticut and
has filed a satisfactory bond and insurance pol cyj the name of the Town -df."96ath-'Windsor:
-� Engineering Department s, „ pate
Connection Charge Paid Permit Fee: Paid
Check Number
r 7 E
f _ ,r. ,t. Issued by
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INSPECTION
Date work started---- ___ _- - - ._-- -- Date completed _ _---
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date