HomeMy WebLinkAboutDrain Layers Permit 549 Rye Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT *^^±
4 19
Pursuant to written application, permission is hereby
named herein to perform the work indicated below at granted to the Licensed Drain Layer
at remis
whose address is
for _
epair House Drain, and to
Lay Main, ___ Other
Family Units with acres. occupancy or use, with
ti
Type of Sewage to be connected under this permit: SANITARY SEWAGE
WASTES ( ), OR ( ) (INDUSTRIAL
Connection will be made with
Show sketch of proposed work or furnish two 2_
1 ( ) ies of separate drawings.
Pi
SPECIAL CONDITIONS
Desired Starting Date
Estimated Time for Completion
Permit to be issued to v
the holder of Drain Layer's License No. ��� �' �L
after date of issuance. Permit will expire thirty (30) days
conditions set forth in the epermitsandetherreverseain esidertb �grees to
a11,the terms and
Town Permit No. � �U� and/or CHD Permit No. � Applicant s received
Signed
Licensed D in Layer
The above named Drain Layer has a valid license iss ed by the tate of Connecticut and
has filed a satisfactory bond and insurance policy f n t name of a Town of South Windsor:
En ineer epartment
Connection Charge Paid 3c/ 1131 " �� Date
��� 4MA Fee: Paid $ " OC>
--�
'\-/Check Number
Tax Ott ice Issued by —
INSPECTION
Date work started
Sufficient notification received: Date completed
Special Conditions Yes No
APPROVED:
Inspec or rAA