HomeMy WebLinkAboutDrain Layers Permit 80 McGrath Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT , 03611
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Pursuant to written application, permission is hereby ranted to th Licensed Drain Layer -
named herein to .perforA the work indicated be ow- tz 1
at premises owned"by A 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.
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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 thin y (30Y- days
after date of issuance. The undersigned brain Layer 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
Licensed .Drain 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 in the name of. the Town`of -South Windsor:
Engineering Department Date
Connection Charge Paid 7 -e_ _ Permit Fee: Paid $
Check NumberLx_,Q�_ _
Issued by.
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date