HomeMy WebLinkAboutDrain Layers Permit 6 Old Parish Drive 77
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT Q3709
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Pursuant to written application, permission is h reb gr nted tot License D ain Layer
named herein to. :per£oXm the wP rk nd ated below at, �,d' �-�Q � �, 5 r
at premises owned by -A ( whose address is
and to
Lay House Drain, Repair House brain, '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". Permit will, expire thirty (30) days
after date of issuance. The undersigned Drain Layer hereby.agrees ,to all the td . and
conditions set forth in the permit and the reverse side thereof. Applicaht'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 to Permit Fee: Paid $
Check Number 1136 0
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date