HomeMy WebLinkAboutDrain Layers Permit 19 Arrowwood Circle TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL ��TT
DRAIN LAYER' _PERMIT NNO, 4 913
1 � , 19C
Pursuant to written application, permission is hereby granted/to the,, Licensed D ain La er
named herein to perfo the ork Indic t d below at �7 � � f
at premises owned by ; 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 ( ), INDUSTRIAL
WASTES ( ), OR ( )
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 toG-C,o
the holder of Drain Layer's License No. 2 7� R y 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. 1
Signed
License rain 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 in the name of the Town of South Windsor:
2 �7
Engi Bring Department Date
Connection Charge Pair# !_ Permit Fee: Paid $ C1 U
Check Number /
Issued by ,� Z- ,; ,
Tax Cif ice
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date