HomeMy WebLinkAboutDrain Layers Permit 1609 Mill Pond Drive ... .. .. -. ,:.;_. .ram.. :._:_, ��.. ., _ , "ry7-.. err •,-,.r-
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TOWN OF SOUTH WW1 N DSR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT N?______3827
Pursuant to written application, permission is h eby ranted o t icens d Dr in Layer
named herein to. per£o the, work in sated: elow- t
at premises owned -by whose:addr s is
and to
Lay House Drain,` Repoir-House Drain, 'Lay 'Main Other ,
for occupancy or use, with
Family Units, with acres.
Type of Sewage to be 'connected under this permit: SANITARY SEWAGE ( ), INDUSTRIAL
WASTES O, OR O< Connection will be made-with
Show sketch of ' work or furnish two 2: co proposed ( ,) pies ofseparate drawings.
SPECIAL CONDITIONS
Desired Starting-,Date `' - Estimated.Timefor .Completion
Permit_ to be iasued"'to
the holder of DraG -Layer',s .Lisenjee No Permit "will expire'`thirty (30)''days
after date of issuance. The undersigrieraL yer hereby. agrees 'to all the tems.'_andi .
conditions set forth in the permit and the reverse side""thereof. Applicant has rece., ved
Town Permit No. and/or CHD Per No.
Signed
Licensed Drain Layer
The above named Drain Lay"er bas a valid license issued by the'State. of 'Cdhtfecticut and
has filed a satisfagtory band "nnd insurance policy in the name of °the,..Town of Soutl`Windsor:
Engineering Department Tate
Connection Charge Paid 79 % Per`tit Fee:" Paid.. $ -
Cheek Number
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED: e
Inspector Date