HomeMy WebLinkAboutDrain Layers Permit 852 Main Street "•i+ji../`i:. �r` �3., r'r.. .. ^- vWa. ti. ;*..
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 3896
3� 19�`
Pursuant to written application, permission is hereby granted to the Licensed/Dir_ai�n Layer
named herein to. perform the work indic ed -b.elow::at // _
at premises owned :by w ose address is
and to; .:
Lay House Drain, kep'iair-House--Diiifti ay Main, T Other
for occupancy or,.�se, 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 for-:Completion
Permit- to be issued to '
...
the holder of Drain Layer's License No. : `. Permit will expire thirty (30) day s
after date of issuance. The undersigned Dram Layer"hereby agiees ;to ail•the- 'terms,:and
conditions set forth in the permit and the reverse side thereof. Applicant has received
e
Town Permit No.. and/or ;CHD Permit, No.:
Signed a .
Li erased' Drai Layer
The above named Drain, Layer ha a valid •license i $ued by the State'-of Connrec'ticut and
has filed a satisfactory bond and insurance pudic ' in the ham of "the own'Of South Windsor:
10
eering Department Date
Connection Charge Paid 0-66 Permit Fee: Paid $
Check Number
( = GZ7 Issued by_
Tax Office
INSPECTION
ate Work started Date comp eted
Sufficient notification received: Yes No
Special Conditions ---------- -- ------------ --- ------- - --r----- -
_ APPR. ED:
Inspector Date