HomeMy WebLinkAboutDrain Layers Permit 70 Krawski Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT "
19�
Pursuant to written application, permission is her nted t the Licen ed Drain Layer
named herein to perform the 3 dicated below at
at premises owned by whose`;address is
and• to
Lay House Drain, ` 'Repair House `Drain, "Lay Maifi, - ' "Other' ,
for occupancy or iT 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 -drawYlgs."•
SPECIAL CONDITIONS
Desired Startift'Date Estimated }Tlme for Completion.
Permit- to be fi§sued to` s'.
the holder of Drain Layer's License No: Permit wtil expire thirty (3 ) -days
after date of issuance. The undersigned ral�yer 'h'ereby agrees o''all the terms and
conditions set forth in the permit and the reverse side thereof. App ,icant has received
Town Permit No•.•_ an`d/or CHD:Permit No. ,
.Signed=:
Lieensed`-Drain-Layer
The above named Drain Layer has_La ,valid' license issued by the State. of'.Connecticut and
has filed a satisfactory bond and insurance policy� .in the name of :the-Town ofSouth Windsor:
Engineering Department �. . Date
7zf
Paid - Permit Fed! Paid $
Check Number d L�
Issued Tiy
ice
INSPECTION
Date work started Data com fete-d ---- —
Sufficient notification received: Yes No
Special Conditions____
APPROVED:
Inspector Date