HomeMy WebLinkAboutDrain Layers Permit 29 Wedgewood TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYE ERMIT
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Pursuant to written appliW permiss hereb ranted to the Licens ed Drain Layer
named herein to perform the . rk indicate � .
at premises owned by whose address is
.,. and to
Lay House Drain, Repair House Drain, FIE
{.ay Main, Otherfor •jo. lccupancy or use, with
Family Units, with acres. 3 ,.$ oi
Type of Sewage to be connected under this permit• '.su'NITARY SEWAGE ( ), INDUSTRIAL
WASTES ( ), OR Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separe drawings.
'
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SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Co le ion
Permit to be issued to
the holder of Drain 'Layer's ,License No. Permit will expire thi (30) days
' aft r date of issuance. The kndersigned DreT Layer hereby agrees to al erms4�nd
itions set forth in the p it and` the iFeverse side theZeof. Applica s receiv
+, own Permit No. 'AHD Permit No.
Signed
Li nsed Drain Layer
The above named Drain LayerY,has a valid license issue 'by th;"`State of Connecticut and
has filed a satisfactory bond and ina�rafce licy in t me of the Town of South Windsor:
r`4�1 *'./�6 v apartment Date
Connection Charge Paid 4� --' P id $
Issued
Tax Office t:-3
INSPECTION
Date work started
-.- Date completed
Sufficient notification received: Yes No'
Special Conditions
1
APPROVED:
Inspector Date