HomeMy WebLinkAboutDrain Layers Permit 250 Nutmeg Road Sout �TOWN OF SOUTH, WINDSOR
DEPARTMENT OF PUBLIC. WORKS
BUREAD OF POLLUTION CONTROL ,
_ #.
DRAIN LAYER F'S PERMIT �. -7-1 tkter-
'`
Pursuant for written application, permission is her
eb • granted to the Li `ensed Drain Lager
named herein ta: perform the work indicate bet at tx n
at premises owned. by ; 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 O, OR { } Connection will be-made-with
Show sketch of. proposed work or furnish two (Z} copies of separate drawings.;
P
.'SPECIAL` CONDITIONS' 2-50 JrJ`
17
Desired Starting_ Date - Estimated Time for Completion
Permit. to be issued tar
the- holder of Drainz Layer's: License No. Permit will expire thirty (30) days -.
after date of issuance. The undersigne = Drain Layer hereby agrees to--al1. the terms and:_
conditions set forth- in the permit and the reverse side th reof. Applicant has received
Town Permit No'.; and/or-,CHD_ Permit No.
i
Signed 0vw� CY
L sed 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. t me of the own of South Windsor:
` -.�-tF7
Engineering Depa tment Date.
Connection Gharg�e Paid , Ur Fermis Fee: Paid $ ,
Check. 7J
G Issued by
Tax Office
INSPECTION'
Date work started Date completed
Sufficient. notification- received:. Yes - No.
Special Conditions
APPROVED:
Inspector Date