HomeMy WebLinkAboutDrain Layers Permit 602 Sandstone Drive TOWN OF SOUTH Wi N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 4.942
19 OC6
f Pursuant to written application, permission is hereby granted� to the Licensed Drain Layer
named herein to perform he work indicated below at . , (opt
at premises owned by whose address is
and to
i
Lay House Drain,''` Rep'iir House'Drain`; '`' "Lay'Main, -r; .. Other ,
for occupancy .br use, with
Family Units, with `acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ), INDUSTRIAL
WASTES ( ), OR (' ) + _ Connection will be medewith
Show sketch of proposed work or furnish two (ZY copies of separate drawings..
SPECIAL CONDITIONS
Desired Starting'Date Estimated Time for. Compl;etion
Permit_ to be issued :to ,,..
the holder of Drain,,Zay%i s Licenge:No ; Per ►i will expire thirty (30) days
after date of issuance. The undersigned Drain Bayer hereby agree's 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
Liedhe6 ..Drain Layer=
The above named Drain Layer has a valid license issued by' the -State of Whnecticut and
has filed a satisfactory bond and insurance policy_in the name of':the`Town of South` Windsor:
u c --
- Engineering .Department J)ate
Connection Charge Paid -//06-y y Permit Fee:' Paid $ �Jr lJ0
Check Number
Issued by .
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date