HomeMy WebLinkAboutDrain Layers Permit 706 Mill Pond Drive TOWN OF SOUTH Wt N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMITT0
19�4
Pursuant to written application, permission is here y r nted tote icens Drain yer
named herein to. perform.,the workA ind'cated bmlaw at. ~' p.� �
at premise's -owned' by' ,, „ dy 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
WASTES ( ), OR ( ) Connection will be-made with
Show sketch of proposed work or furnish two (2) copies of separate drawings:
SPECIAL CONDITIONS
Desired Starting Date f Estimated Time for' Completion
Permit. to be issued"to
the holder of 'Drain`Lay'er'. ' ` cense No:. . Permit Wiil e 4d thirty (30)` days
after date of issuance. The undersigned Dra n_'Tayer hereby agrees_.tc ai the terms and
conditions set forth in the permit and the reverse side thereof. Applicant has received
Town Permit Now and/or,CHD Permit No.,
Signed
Li efensed i_Drain Layer
The above named Drain Layer has. a valid' license issued` by the Stare. Af-`Connecticut and
has filed a satis€actAry bond and insurance policy in..the name',of the Town of:'South Windsor:
Engineering Department Date
Connection ge Paid �. Permit Fee: Paid $
Check Number.
A.12 _,fd Issued by
Tax Office ,
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date