HomeMy WebLinkAboutDrain Layers Permit 605 Sandstone Drive ffr., '�`_ ,x...-
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT NO 40919
-2 19 d'9
Pursuant to written application, permission is hereby t d to the icensed Drain Layer
=elow named herein to. perform the rk Indi at O.S ,
at premises owned by whose address is
and to
Lay House DraintRepair 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 f or. Completion
Permit. to be issued `to
the holder of Drain Layer's -License No. 'Permit will expire thirty (30) days
after date 4f' issuance. The undersigned Drainyes hereby agrees 'to all tYe' terms 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 .valid license issued by the 'State of Connecticut and
has filed a satisfactory bond- and insurance policy in.ifie name of the Town of South Windsor:
Engineering Department Mate
Connection Charge Paid 'yL'�� '/ �% Permit Fee: Paid
Check N er � `J
-' Issued by
Tax Q�ffice
��T
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date