HomeMy WebLinkAboutDrain Layers Permit 56 Rockledge Drive .:...gr•..ils..,..
TOWN OF SOUTH W1 N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT v3654
&C�K(tdqz> 5
Pursuant to written application, permission is her b granted to the Licensed Drain Layer
named herein to perform::t4ej work indicated below-at.--,
at premises-dVited• :by �;.rlgm�r - whose;-address is
_ ,. . .. . end,
Lay House Degiti, dp"dir 1Toti e` Drain; Lay- in,
for �• ��f T T}occu�Sahc Qr.u' With`
i Family Units, with acres
Type of Sewage to be connected under this permit: SANITARY SEWAGE INDUSTRIAL
WASTES ( ), OR ..{ )::,: Connection wi3 h:;be 1►ade wwith
!/ J, t C
Show sketch of propose,;work or furnish two (2`) copies of separate drawings
SPECIAL CONDITIONS ,t
Desired Starting Date �. Estimated,:-Time fe�.r ::Comp1-etion };
t, VT_ 'fir;
Permit_ to ba issued t¢
r
the holder_of _braid `ear', ka •::.: Aga)=.nays
Y'
after date of issuance. The unders#gned rain payer hereby agrees; o ,al the`f� s' and
conditions set forth in the permit and the reverse side thereof.' Applicant`tas received
Town Permit Na, and/or CIA Permit: No a ;.
Signed
_ tic-erised,`Drain-..Layet
The above named Drain Layer has a valid '11censo isaie'd b the `State of Connec fcut and
has filed a satisactQry , Qd and insurance, pa],icy :t '` qi ';t_he To,m' ofa-§"out 'Windsor:
s <<
Engineer ng apartment• zrI?ate
Connection Charge Paid
Check
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date