HomeMy WebLinkAboutDrain Layers Permit 661 Pleasant Valley TOWN OF SOUTH WI N DSOR
per► DEPARTMENT OF PUBLIC WORKS
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BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 773
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Pursuant to written application, permission is hereb,y raty�e to the iZm �,y
sed Drain Layer
named herein to. perform .t a work indicated beow at ��r (/ Qp
at premises owned by L cam: whose address is
and -toy
La House Drain ` Re air=House Drain, .!Lay, ,Y P y 0`t•her
for —T 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 �6 . `
the holder of Drain: Layer's 'Lice se T �Pe mit -Will expire-thirty (30)`days
after date of issuance. The undersigns Drain ayer Hereby agrees..,t6 all 'the tejmis: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 brain Layer has a"- valid license issued by the Stater of Connecticut and
has filed .a satisfactory. bond..-and iisuranoe policy in the name of''the down of-' butte Windsor:
-M-g±Seel-ing-De—parNment,.; Date !
Connection Cha a Paid Permit Feei."Paid
Check Number- 311,
Issued by
7 Tax Office
INSPECTION
Date work started Date completed
Sufficient" notification received: Yes No
Special Conditions
APPROVED:
Inspector Date