HomeMy WebLinkAboutDrain Layers Permit 610 Sandstone Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT Q4044
C7 'c� , 19 04�6
Pursuant to written application, permission is hereby ante to the Licensed Drain Layer
named herein to. perform the work indicated. below at (P/U :; Ce. V
at premises owned by �� � l�.�CYo, A whose-,address is
and to- ..
Lay House D'rain,' '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 `lie issued to
the holder of Drait}'_,L4yer',p.:Ltenpe4 _.,_'. _,, Permit_will, 0Xpire_thirty (3.9)` days
after date of issuance. The undersigned Drain Layer hereby agtees .to all the 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, y
Licensed Drain.:Layer
The above named Drain Layer has a_valid''license issued.by- the State: of.Connedticut and
has filed a satisfactory bond and insurance policy. 'in the name of the flown of'.SouthWindsor:
vv�
Engineering Department Date
Connection Charge Paid ad .90 Permit Fee: Paid $ ,U�
Check Number
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date