HomeMy WebLinkAboutDrain Layers Permit 81 Saddleback Drive TOWN OF SOUTH WIN DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL ��TT
DRAIN LAYER'S PERMIT NNO, 4729
Aod"azK Dr -
Pursuant to written application, permission is her/ev, nted the Licensed Drain Layer
named herein to perform the work indica ed below at 1 ✓ ,
at premises owned by
2 <1 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's License No. Zo 2 Permit will expire thirty (30:) days
after date of issuance. The undersigned Drain ayes reby agrees to all the terms and
conditions set forth in the permit and the reverse ide thereof. Applicant a/rived
Town Permit No. and/or CHD Permit No.
Signed _f /
License "rain 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 i the name of the Town of South Windsor:
Engineering Department Date
ConnectionFlife Paid (U Permit Fee: Paid $
�.� Check Nut}beie (/
Q-
� Issued by
Tax Office
INSPECTION /
Date work started /o Date completed
Sufficient notification received: Ye' s — No
Special Conditions
APPROVED• 6777-9-7
Inspector pate