HomeMy WebLinkAboutDrain Layers Permit 1602 Mill Pond Drive TOWN OF SOUTH WI N D:SOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL-;
WID
DRAIN LAYER'S PERMIT 3820
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Pursuant to written application, permission is eby ra to to Licen ed ,D ain Layer
named herein to. perfo t work ' icat_ed below at
at premises owned by whose add ss is
4 and to. -
Lay House Drain; Repair House'`Drain' Lay Main, Other
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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
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Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for, Completion
Permit, to be, issued, to
the holder of Drain-Layer's`License No.. _: ' Per6it will expire thirty (30)'-,:days
after date of issuance. The undersigned Drain Layer hereby agrees_to `a�l 'the terins ,and
conditions set forth in the permit and the reverse side thereof, 'Applicant has-received
Town Permit No. _. and/or XHD Permit No.,,
Signed
Licdn:sed Draift Layer
The above named Frain Layer has a' valid. license issued by the"State' of Connecticut and
has filed a satisfactory bond. and insurance, policy.;;in the name of. the Town of;.S6ut4 Windsor:
-]Engineering:Department Date
Connection Charge Paid8'/Q �'� Per'm `Feed Paid $ (�
.Check Number _
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issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector pate