HomeMy WebLinkAboutDrain Layers Permit 1706 Mill Pond Drive <y., ,"+. _ .y.. , an• ram;�p+: w _ t^ ;'�� .. r ',... ..e
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT v�_
, 19yJ
Pursuant to written application, permission is ebW ra ted to a Lic used Drain Layer
named herein to. perfo the work i caged below t ��(�
at premises owned by whose amAress is
and to
Lay House Drain,' =Repair`House Drain;' Zay Main, Other-
for sccupancy or use, with'
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE O, INDUSTRIAL
WASTES ( ), OR, ( ) Connection will be made with
Show sketch of proposed work or furnish two' (2) copies of separate drawings.
/7d,6 wll c_O
SPECIAL CONDITIONS
Desired Starting Date Estimated Tame for Completion. .
Permit- to be issued 'to
the holder of brain Layer's Lcense.Nq." Permit will expire.thirtq (30) days
after date of issuance. The undersigned Dra— aver{hereby agrees: to all tie teams-and
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No: and/or CHD:Permit No.
Signed
:, hicensed Drain-Layer,:
The above named. Drain Layer has a valid 1icense issued by `the State of Connecticut aqd
has filed a satisfactory bond, and insurance policy _An`,the name of; ,the Town 'of` South'
.Windsor:
&YgInAring Department Date
P ,
Connection Charge Paid F 16-4 Aij Permit Fee: Paid $ �
Check Number �.
Issued by '
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date