HomeMy WebLinkAboutDrain Layers Permit 401 Mill Pond Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
} DRAIN LAYER'S PERMIT 3995
LC�131 1 90L)i
Pursuant to written application, permission is hereby gr nted t the icfnsed Drain Layer
named herein to perfo the work i cat.ed eiow at
at premises -owned,-by whose address 3s
and to
Lay House Drain, Repair 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 ( ), OR ( ) Connection will be.made:with
Show sketch of proposed workor furnish two' (2) copies of separate drawings
SPECIAL CONDITIONS
Desired Startj:tig Date Estimated Time for .Completion -
Permit- to -be issued to
the holder of brain Layer Is license No.. 'Permit will ekpire thirty 00')'"days
after date of issVance. The undersigned DTn Layer hereby agrees to all the' tekms' and
conditions set forth in the permit and the reverse side thereof. Applicant has -receivedTown, Permit No.. and/or CHD Permit No. - .
Signed
Licensed- Drain Layer
The above name rain Layer has a .valid license issued. by .the State `of Connecticut and
has filed a satisfactory bond and insurance,po.liey 'n ;e name of ,the Town of': South Windsor:
Engine ing Department Date
Connection Charge Paid "'' Permit Fee:' Paid $ '�
Check Number
Issued by
Tax Otrice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date