HomeMy WebLinkAboutDrain Layers Permit 127 Morgan Farms Roa TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT �} 5063
19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform" the work indicated below at
at premises owned by ; , —'--'- c 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 E Estimated Time for Completion
Permit to be issued ,to
the holder of Drain Layer's License No. Permit dill ekpire thirty (30) days
after date of issuance. The undersigned Drain Layer reby agrees to all the terms and
conditions set forth in, the permit and the reverse sid thereof. Applicant has received _.
Town Permit No. and./or CHD Permit No.
Signed
Licensed D ain Layer
The above named Drain Layer has a valid liens'' 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 ��'G� "�� y Permit Fee: Paid $ r%Ll}
Check Number%!, ;
' -t,� Issued by
Tax Ofice
INSPECTION
Date work started ..'Date completed
Sufficient noti£,jation received: Yes No
Special Conditions
APPROVED:
Inspector Date