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HomeMy WebLinkAboutDrain Layers Permit 23 Victor Lane i TOWN OF SOUTH WI N DSOR DEPARTMENT :OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT NO 4279 a3vdcizruax--Q, Pursuan to written application, emission is hereby grant d t© 'the L. ;cenped Drain La e named herein to perfo the wor indic ed. bel0ii 47E at pre ises ed by ( , t w o address is and to L House Drain, Repair House Drain, Lay Main, Other { ,xpr occupancy or use, with i 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 work or furnish proposed two (2) copies of separate drawings. SPECIAL CONDITIONS Desi-ked' Starting bate Estimated Time for Completion s Permit to be issued to the holder of Drain Layer's License No. 7 S Permit will expire thirty (30) days after date of issuance. The undersigned Drain Layer hereby agrees to all the terms and conditions set forth ,in the permit and the reverse side thereof. Applicant has received Town Permit No. and/or CHD Permit No. Signed C Licensed Drain aver 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: eering Department Date Connection Charge Paid/- f , -> Permit Fee: Paid $ (� Check Number �j ,fir .% Issued by Tax Office INSPECTION Date work started Date completed Sufficient notification received: Yes No Special Conditions APPROVED: Inspector pate