HomeMy WebLinkAboutDrain Layers Permit 126 Krawski Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT `
Pursuant to written application, permission is here y�g anted to the Licensed Drain Layer
named herein to perfo e ork indicated below at b , ��
at premises owned, by � ,�,� „
whose address is
Lay House Drain, Repair `House Drain, and to
for ;.Lay Main, Other ,
Family Units, with acres. occupancy o'r' use, with
Type of Sewage to be connected undWASTES gRer this permit: SANITARY
Connection will be made with
o IrwC_
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for,Completi.on
Permit- to be issued to
the holder of Drain Layer's License No. Permit will expire;'thi f3O) da
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 receive
Town Permit No, ,and/or CHD Permit No.,, d
Signed.
Licensed Drain Layer
The above named brain Layer has a valid license issued by the State of
,Conn'ecticut and
has filed a satisfactory bond and insurance' policy,.,in. the .name of the To of South. Windsor:
015
Engineering Department -Date
Connection Charge Paid Permit Fee: Paid
Check Number3(Ildr
Issued by
Tax f �rr
INSPECTION
Date work started Date completed
Sufficient notification received: - - -- -
Yes--- - —iVo -
Special Conditions
APPROVED': - - _ -
Inspector Date