HomeMy WebLinkAboutDrain Layers Permit 54 Overlook Road TOWN` OF SOUTH W1 N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT +a 0
L S
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to.;perform the o indicated :below at Sy
at premises owned by.,. n > _►r •..whose_address is
3 sand'to
Lay House Drain,. .' Repair`louse `Draih, Lay Mani, ,k:; Other ,
'T^ occupancy or use, with
-
for
y
for ., .. .. .
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 tIvo `(2) 'c6pies of separate drawings:
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SPECIAL CONDITIONS
Desired Starting Date -3� -
Estimated :Tim for. Completion,
Permit to be issued to
the holder of Drain Layer's. cense P i will expire-thirty (30) days
after date of issuance. The undersigned Drain .'ayer hereby '_a*Tees` to 'alb 'the'teriris.,and
conditions set forth in the permit and the reverse side thereof. Applicant h received
Town Permit No. ::; ..,and/or CHD Permit NO.-
Signed
Licensed D in Layer
The above named Drain sayer ha4 a .v�lid license issued b� hey State of':Connectcut and
,. :
has filed a satisfactory, band] and insurance policy tame, Q . the , own wf Soiith'Windsor:
Eng n ring ,De ent -Date
Connectio Charge Paid 3k
Permit Fee: -Paid-
Permit
o Check Nu C!
k.
i
Issued by, _
Tax office
\ INSPECTION ^2 S
Date work started 8 Date completed Z(n r 8�
sufficient notification received: Yes No
vecial Conditions
Inspector pate