HomeMy WebLinkAboutDrain Layers Permit 1846 Main Street � __..,,..,. _...: ...... _ -.. ....... . . .,��.., ;,w w .,,� � -err s•"„�,1e ��"--^:� _ , ... y ..
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--TOWN- -OF -- SO- UTH W1 N DSOR -
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
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DRAIN LAYER'S PERMIT 0 4610
--� 19 . %
Pursuant to written application, permission is hereby granted to th icensed Drain Layer
named herein to perform a wo k indices ed below at /�'`�lo
at premises owned by W . whose address is
and to
Lay House Drain, Repair House Drain, Lay Main, Other ,
for occupancy or use, 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 �? t Estimated Time for Completion
Permit to be issued to ��
the holder of Drain Layer's License No. Permit will expire thirty (30) days
after date of issuance. The undersigned Drain ' ayer hereby agrees to all the terms and
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No. and/or CHD Permit No.
Signed ad,,-ztll
Licensed in Layer
The above named Drain Layer has a valid license issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy i�)the nre,of the Town of South Windsor:
Engineering DeparYient Date
Connection Charge Paid Permit Fee: Paid $f ✓j 1 S A
Check Number S,S
Issued by
Tax Office
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INSPECTION
Date work started Date comp ete
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date