HomeMy WebLinkAboutDrain Layers Permit 60 Krawski Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT Q4076
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Pursuant to written application, permission is hereby ran ed to t e L censed Drain Layer
named herein to. per£o a word in below:at.
at premises owned by whose address is
and to
Lay House Drain, Rep'ai `House"Dr -Main,
for occupancy oruse,• 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:
SPECIAL CONDITIONS
Desired Starting:Date 'Estimated Time fbr. Ca letion
Permit- to be issued -to
the holder of Dra n:ftayer ,s -Lid Permit w a re-thirty O) 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 thereon. Applicant has received
Town Permit No. ::,:, ;;$nd/or: OHD .Permit. Net.,
Signed
Licensed.Dvain Layer:
The above named; Drain Layer has. a valid" l1 nse issued by.the Estate of Connecticut and
has filed a satisfactory bond snd i surarce policy in .t dame of- the'To of''s"buth.'Windsor:
- - ngineering Department .Date
Connection Charge Paid �, Per�tit Fee: Paid $
Check Number ((A �.CL�
Is§ued by-
Tax Office
INSPECTION
Date work started- Date complete
Sufficient notification received: Yes No
Special_Conditions-__
APPROVED:
\ Inspector Date