HomeMy WebLinkAboutDrain Layers Permit 96 Rockledge Drive/ TOWN OF SOUTH WIN DSOR
DEPARTMENT OF PUBLIC WORKS
Pfl- BUREAU OF POLLUTION CONTROL
C�/ .wa DRAIN LAYER'S PERM o�_ 4949
Pursuant to-written application, permission is here granted t the Lic sed Drain Layer
named herein to perform- theyoSk indicated below at
at premises awned by - whose address is
and to.
Lay House Dr in, Repair'House Drain, Lay Main, Other. ,
for occupahcy 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-- `
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SPECIAL CONDITIONS:.
Desired Start3n.g Date � n far Completion
Permit to Abe issued -
-- ---- hg holder of_ r 4 e 4+_: days_
after date of issuanc sign -- ay er .,er br tj s o a the`terms and
conditions set iforth in.,t n g and ,tMe reuerse--sidT thereof. Applicant lias received
Town Permit No-.. fXh4lor--:OHD::Permit No."
u.t Signed
Licensed'Drain-Layer
The above named Drain Layer has a valid "1"icens- issued by' the State of Conne+ ticut and
has filed a satisfactory. bond and insurance policy in the of the Town of `South Windsor:
t
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Engineering lepartment . ,; Date
Connection Chargead' (J� Z` Permit Fee: Paid $
Check Number
i'
Issued by
Tax Office 70
INSPECTION $ ,;,�`
Date work started '+ t., Date completed T_= �
Sufficient notification rec ived: Yes No
Special Conditions
APPRO
d; Insp ctor Date