HomeMy WebLinkAboutDrain Layers Permit 1308 Mill Pond Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 0. 4387
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Pursuant to written application, permission is hereby ranted t the,L' ensed Drain Layer
named herein to perform he work indigated below at �- ��
at premises owned by 14. U < �oJ, - 1�'
whose address is
Lay House Drain and to
Repair House Drain, Lay Main,
for ___ Other
Fain acres.
ily Units, with occupancy or use, with
Type of Sewage to be connected under this permit: SANITARY SEWAGE
WASTES ( ), OR ( ) ( ), INDUSTRIAL
Connection will be made with
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 1, r/ l ._-,z , �~x
after date of issuance. The undersigned Drain tayer hereby agreesx tor
allh they
terms ands
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 Layer
The above named Drain Layer has a valid license issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy 'n,\e e of the Town of South Windsor:
gineerin Departm nt Date
Connection Charge Paid _'y'j%), (Jl� Permit Fee: Paid $ t1 U
Check Number ���
( A" Issued by
u Tax Office
INSPECTION
Date work started
Sufficient notification received: Date completed
Special Conditions Yes No
APPROVED:
Inspector pate