HomeMy WebLinkAboutDrain Layers Permit 131 Scantic Meadow R (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL ��TT
DRAIN LAYER'S PERMIT Me. 4860
19
Pursuant to written application, permission is hereby granted to the Licensed rain Layer
named herein to perform the work Andicated below at Y3i � �t.
at premises owned by ,i whose address is
�' iand to
Lay House Drain, Repair House Drain, Lay Main, Other ,
for occupancy or use, with
Family Units, with acres.
Type of Sewage to be conneceed 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 'me for Completion
1
Permit to be issued to
the holder of Drain Layer's License No. ; Permit will expi Dirty (30) days
after date of issuance. The undersigns rain Layer hereby agre s l Ithe terms and
conditions set forth in,the permit and the reverse side thereof�/1 pl ant has received
Town Permit No.,., and/or CHD Permit No.
Signed
Lic6is d ain Layer
The above named Drain Layer has a valid license issued by the a of Connecticut and
has filed a satisfactory bond and insurance policy in the name o e Town of South Windsor:
Engineering D artment Date
Connection Charge Paid � /C�j� (� Permit Fee: Paid $
Check Number r�
Issued by
Tax fffice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date