HomeMy WebLinkAboutDrain Layers Permit 92 Morgan Farms Road . ... �.: ;-.., ,.. ;;,.;. .o.•:-: �y�..�-.: �,�R' .�i�Rxa 3•� ,r•:�:!fi'�.... "'� i¢tf•7� aayt;�+. ".YPfar'cCi'�Y:�"'..7��. . � ., —'°` `' . .,
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT X0 4454
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Pursuant to written application, permission is ereby grant d to the..i,icensed �Drain Layer
named herein to perfoM the ,wor indicated below at
at premises owned byf,
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 Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No. �� c/S�/. Permit will expire thirty (30) days
Y
after date of issuance. The undersigned Drain Layer hereby agrees to all the term ..and
conditions set forth in the permit and the reverse side thezLicensed
Applicant ha eceiv
Town Permit No. and/or CHD Permit No.Signed 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 Towp of South Windsor:
Engineering Departm nt Date
Connection Paid Charge
g Permit Fee: Paid $ 1r !)j
Check Number
IUD ` Issued by
�I Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date