HomeMy WebLinkAboutDrain Layers Permit 85 Nutmeg Road South (2) `` .� 3, .. . ,,,�..,,,..,, ..i. `f•• _.yn.i•r7v :.. ;,'?Ri:_"'7,'.:4.,A`llM1�' ,`17,7, k `'i?��?.E-s'
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT O 3834
t4
O z '. 19 , �...
Pursuant to written application, permission is hereb ' granted to th Licensed Drain Layer
Fd herein to perform thewo indicated below at:j'S'
,premises 'owned. by whose address is
and to
House Drain,, " Repair House Drain.; 'Lay Main,``'` Other' ,
jr occupancy or use, with
amily 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'.Lidwhse No. . Permit`will expire thirty (30) days
after date of issuance. The undersigned brain Layer hereby ,agrees to all :the to ms 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 validlicense issued by the State of Conneeticut and
has filed a satisfactory bond and insurance policy tine name. of .the Town of Soiitl..Windsor:
Engineering Department. -Date
Connection C e Paid . 70T Z If Permit Fee: paid
Check Numbeg ---,
Issued by
Tax office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date