HomeMy WebLinkAboutDrain Layers Permit 702 Mill Pond Drive TOWN OF SOUTH Wi N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 057
199
Pursuant to written application, permission is hereby anted to the Licensed Drain Layer
named herein to. perform:.the work indicated b ow at e
at premise's owned-by whose address is
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 j
WASTES ( ), OR ( ) Connection will be made with i
Show sketch of proposed work or furnish two (2) copies of separate drawi2gs.
k
7
SPECIAL CONDITIONS ,.
Desired Starting"'Da.te x.. Estimated Time for Completion. .
Permit- to be issued to -
the holder of Drain, Layer's License Nq.. .. . , Permit will expire; thirty "(IGY days
after date of issuance. The undersigned Drain layer hereby sgreQs to all the'terig'and
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit No: _ and/or-,CHD Permit- No.
Signed
Licensed. -Drain,Layeir
The above named. , rain Layer has "a valid .license issued by the' Staie,of Connecticut and
has filed a satisfactory bond and insurance policy in. th6 name of the Town of'; South Windsor:
- Engineering Department bate
Connection Charge Paid .Permit Feel Paid
Check Nu
'Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date