HomeMy WebLinkAboutDrain Layers Permit 990 Strong Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT o. 424
Pursuant to written application, permission is her 7by�r t d to the ensed Drain Layer
named herein to- perform the work indicated below at �I�f�j''
at premises owned by QA, ,n
whose address is
Lay House Drain, Repair House Drain, and to
for Lay Main, Other
Family Units, with acres. 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 No.
. Permit will expire thirt, (30) days
after date of issuance. The undersigned-Drain Layer hereby agrees- o- l th terms and
coed t-ions set forth in the permit and the reverse side thereof. li ; as received
Town Permit No. and/or ant CHD Permit No. i /
Signed 7
L
ice ed Dr Layer
The above named Drain Layer has a valid license issued by t e�Statee^of�06nnecticut and
has filed a satisfactory bond and insurance policy in the name o _tf` he_.TOW6of South Windsor:
Engineering Department Date
Connection Charge Paid ,S �� Permit Fee: Paid $ �S���� -
-� Check umber14- SSj
Tax office Issued by
INSPECTION
Date work started
Sufficient notification received: Date completed
Yes No
Special Conditions
APPROVED:
_-Inspector Date