HomeMy WebLinkAboutDrain Layers Permit 56 Stonefield Trail -71
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 362.5
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Pursuant to written application, permission is ereby $,ra d i to t e Li nsed D an Layer
named herein to perforMthe work indicated below ;at ; vC
at premises owned by whose a dress is
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- and to
Lay House Drain, Repair House Drain, Lay Main, Other j
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 411 Ws Estimated Time for Completion /g ,-
Permit_ to be issued to
the holder of Draie„Laygr.' :-License No. 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 _
Licensed Drain Layer
The above named Drain Layer has a valid-license issued by the State. of C6hnecticut and
has filed a satisfactory bond and insurance policy,,; in/t�he ns�ne of the Town of South Windsor:
��• RSA
Engineering .Department Date
Connection Charge Paid VOO•'a 0 r �� Permit Fee: Paid $
Check Number
l l ' Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date