HomeMy WebLinkAboutDrain Layers Permit 54 Steep Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYERS PERMIT
5752
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work ndicat dl;ow
C at emises owned by - � a hQ
j whose address is + and to
Lay House Drain, epair Hous Drain, Lay Main, Other , ,
for c , v 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
IF
Permit: to be issued to co f. c rvC
r
the holder of Drain Layer's Li ense No. 0 Permit will expire thirty
(30) days after date of issuance. The undersigned Drain, Layer hereby. agrees
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
;?nse
ensed Drain Layer
The above named Drain Layer has a valid 1 issued by the State of
Connecticut and has filed a satisfactory b nd nd insurance policy in the
name of the Town of South Windsor:
n ine g Dept. Date
Permit Fee Paid $ 0 Ch ecl N mberf
Connection Charge Receipt No. 14- ated
Issued by
71 `�q
INSPECTION
Date work started Da a completed � L/' U
Sufficient notification rece ve : es No
Special Conditions
I/ r , W4Lf APPROVED:
L ''v Inspector Date
/� l�r 0