HomeMy WebLinkAboutDrain Layers Permit 5 Stanley Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 0 3755
/d— 1901
Pursuant to written application, permission is hereby ranted t the Licensed Drain Layer
named herein to-perform.-t e w rk4ndicat:ed below at add whose- ress is
at remises owned b
and to
Lay House Drain`; ' Repair House Drain;° 'Lay Main, " Other ,
for - occupaftcy 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 'furni`sh two; (2) Copies'of separate drawings.
SPECIAL CONDITIONS
Desired Starting-Date Estimated .Time for-Completion -
Permit- to be issued to _. .
the holder of Dra3 Zayer,'•s:'License Nq." :` Permit 'w 1 expi>a thirty (30,) °days
after date of issuance. The undersigned rain La 'er hereby agrees to all the terns .and
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No. and/or. -CHD Permit No.. rLL
-
Signed ar
icen ed Drain-,Layer
The above named- Drain Layer has"a ,valid license issued' by the State of Connecticut and
has filed a satisfactory bond, and" ;nsurance polic._y i the name,of the Town of: Soutt `Windsor:
;. Engineering -.Department. J)ate
Connection Charge Paid ��o .Q y - /Pei`kit Fees paid'
Check Number
9 _ L issued by
j Tax Office .
lw�64
INSPE TION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date