HomeMy WebLinkAboutDrain Layers Permit 1136 Main Street DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
j R -30
DRAIN LAYER'S PERMIT 36
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform the work dicat d below at,
at premises owned by b whose address is
and, to
Lay House Drain`; Repair-'House Dta n, „Lay Main, Otlei� ,
for ' T_ooccupancy or use, with
Family Units, with acres. j
Type of Sewage to be connected and thi p rmit: SANITARY SEWAGE ( ), INDUSTRIAL
WASTES ( ), OR ( ) l� (�_ Connection will be.made with
.fig
Show sketch of proposed work or 'tirnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date - stimated Time for Completion
Permit- to be issued to
the holder of Drain':Layer IS Iicens'e Pe .it will dkoire thirty (!O)''days
after date of issuance. The undersigned Drain Layer hereby agrees 'to a 1 AI',the 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`DrainILayer
The above named Drain Layer has 'A' valid license issued by the state of Connecticut and
has filed a satisfactory bond. and insurance.. policy. in'-.the name of the Town of South Windsor:
Engineering Department- Date
d
Connection Charge Paid M6 U 0 Permit'Fee: Paid $
Check Numb
—n j t C C 7 7(� Issued B
Tax Off*c
_INSP CTION
Date tarted Date comp ete
Sufficient notification received: Yes No
Special Conditions_
— APPROVED: -
Inspector Date