HomeMy WebLinkAboutDrain Layers Permit 34 Victor Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT . 4.393
34 V i car Low.
Pursuant to written application, permission is hereby granted to the icensed Drain Layer
named herein to perform -the work i�}c�icated be) at j �C U , t',] n E'
at premises owned by i -' whose address is
Lay House Drain, Repair House Drain, Lay Main, and to
for or "se, with Other
Family Units, with acres. occupancy
Type of Sewage to be connected under this permit: SANITARY SEWAGE '( , INDUSTRIAL
WASTES ( ), OR ( ) Con c ion will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPEC
IAL CONDITIONS
Desired Starting Date EstdLZated, T e r Completion
Permit to be issued to
the holder of Drain Layer's License No. Perini will txpire thirty 30) day
after date of issuance. The undersigned Drain Layer hereW agrees to all the terms and
conditions set forth in the permit and the reverse side thereof. pplicant has rece' ed
"Town Permit No. and/or CHD Permit No.
Signed
Licensed Drain r
kO
The above named Drain Layer has a valid license issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
Engineering Department Date
Connection Charge Paid q j $ Permit Fee: Paid $ l (�
Check Number
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date