HomeMy WebLinkAboutDrain Layers Permit 1709 Mill Pond Drive •...-. .,fr .: , .:,.rr. .?,::k, ,,._, tr-+m .v .Ti ^rz":_..r•^' .. .. :"` • -t - . - r .t:.
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TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT ID
19��
Pursuant to written application, permission is eby a ted o the Lice d D aip, Layer
named herein to. perfo ;t a work i icat d'bel w .at; ( ,0 h .
at premises owned .by r whose:addiress is
and to
Lay House Drain; Re' air'House Drain, 'Lay,,Main,y for occupancy
or use,' with'
Family Units, with acres.
i
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ), INDUSTRIAL
WASTES ( ), OR ( ) Connection will: be Made with
F
Show sketch of proposed work or furnish two (2) 1cop es of`separate `driwings.
F:rn r
SPECIAL CONDITIONS
Desired Starting Date .Estimated Time .f,oi Completion ,,.,
Permit- to be issued"to' ;
the holder of Dra r};..Laygr -s -ttLe,ense N .. . :a ` , �:. Pettit,Wi11 xpire..'thiicty, (30)',idays
after date of issuance. The undersigned Drain Layer here(iy agrees- t all the terts_and
conditions set forth in the permit and the reverse side thereof ' Appiicant has received
Town Permit No. and/or. CHD.Permit No.
r. Signed
Licensed Drain,Layer..
The above named Drain,tayer as a valid license issuedy the State of••C6nnecticut and
has filed a satisfactory bpnd and .insurance. policy in the name of the Town of So�utt`Windsor:
En inee in De ar ment ate
g P t D
Connection Charge Paid � ad Permit 'Fe, 'Paid
Check Number
r� Issued by
Tax office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector �_ Date -