HomeMy WebLinkAboutDrain Layers Permit 98 Natsisky Farm Roa TOWN QF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
4
DRAIN LAYER'S PERMIT, 4551
19
95 �S1511� �+m 2 � Cj,l
Pursuant to written application, permission is ereby grant t the
named herein to perfo the wo indices d b w a _ Licensed Drain er
at premises owned by
ose address is
Lay House Drain and to
, Repair House Drain,- La Main for y , Other
Family Units, with acres. occupancy or use, with
Type of Sewage to be connected under this permit: SANITARY SEWAGE
WASTES ( ), OR ( ) ( ), INDUSTRIAL
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 Licse No. f m
after date of issuance. The undeenrsigne Drain Layer hereby greesxtorallh the yterms ands
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 ( J;� Permit Fee: Paid $ ,,
i �
Check Number ��_
Issued by
Tax Gffice
l
INSPECTION
Date work started
Sufficient notification received: Yes Date completed
Special Conditions No
APPROVED:
Inspector pate