HomeMy WebLinkAboutDrain Layers Permit 604 Sandstone Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT o 998
2 Z; 19 A6
Pursuant to written application, permission is herebyran g d o the icens d D ain Layer
named herein to perform the k indicate .b low..at �� :. 0.
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 ( ), 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 .. lic4nse No. e Permit will -expire_'thirty (30`)' days
After date of issuance. The undersigned Drams Layer hereby agrees `to all,:tYe' terms and
conditions set forth in the permit and the reverse side thereof. Appiicant 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 to
Connection Charge Paid / a V Permit "Fee: Paid $ / L
Check Number
A),� Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector pate