HomeMy WebLinkAboutDrain Layers Permit 1702 Mill Pond Drive TOWN OF SOUTH WIN 03 ;
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DEPARTMENT OF PUBLIC WORKS , s
BUREAU OF POLLUTION CONTROL r J
DRAIN LAYER'S PERMIT = " No3811
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t g?
Pursuant to written application, permission is reby granted to a Lice sec} rain Layer
named herein to perfo t e work dicated bel01' t
at premises 'owned by U AV : . whose &d ess is
and -to
Lay House Drain, repair oue Drain., Lay Main,
for occupancy or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWACE { ), INDUSTRIAL
WASTES ( ), OR (: ) Connection will be made with
Show sketch of proposed work or furnish '6401ta copies of separate drawings:
SPECIAL CONDITIONS'
Desired Starting 'Date Estimated Time'.for:;Completion
Permit, to be issued- to'
the holder of 'Draizi; Layer's license No. r:'Permit will expire thrrty (3(3')'''days
after date of issuance. The undersigned Drain.Layer 'hereby ._4grees `to all the` fer 'o'and
conditions set forth in the permit and the reverse side thereof. - Applicant fias `r'eceived
Town Permit No..... , and oz:,CHD Permit Np.;.:
Signed
_ _ Licensed Drain Layer.;
The above named Ur in Layer has. a valid license iss#ied' by the State of` Connecticut and
has filed a satisfactory bond and insurance policy in th of the Town of, South Windsor:
:T _ Engineering.,Department Date
Connection Charge Paid Permit fee: Paid $ r Q
Check Number
Is"sued by:
Tax Office fi
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date