HomeMy WebLinkAboutDrain Layers Permit Strong Road (2) TOWN OF SOUTH W�I s N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 90 '
19 cfnb
Pursuant to written application, permission is hereby granied to the Licensed Drain Layer
named herein to perform the =dicatpd-below,at
at premises `owned by c-
whoseaddres7s is
and to_ "!
Lay House Drain, Repair House Drain, " 'I;ay Main, Outer
for -�— ,
occupancy or use, with -
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE INDUSTRIAL
WASTES ( ), OR {. ) Connection wi 1 be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
S E-:- C oo�
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SPECIAL CONDITIONS
Desired Starting Date Estimated :Time for Completion
Permit, to be issued to the holder of Drain. dense No '? Permit will expire thirty (30)`sd s
—conditions setiforthcin t eepermit and thereof sAto`al��`the 'tes� and
h pplicant has received
Town Permit No. �; and/or CHD Permit No. �.
Signe i 1
icen'ble& Drain Layer
The above named Drain Layer has a valid license issued by the State of Connekticut and
has filed a satisfactory bond and insurance po,,lic i the name.of the flown of Sout1 Windsor:
nginee ing Dep rtment Date
Connection Charge Pai Permit Fee, Paid $ -
Check Number
Issued by -
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector pate
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�of
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