HomeMy WebLinkAboutDrain Layers Permit 430 Benedict Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT N 2 5235
Pursuant to written application, permission is hereby granted to the Lic ed Drain Layer
named herein to perform the work indicated low a
at premises owned by ULG whose address is
and to
Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use, with _s q
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE Ll,--INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
42
Show sketch of proposed work or furnish two (2) copies of separate drawings.
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SPECIAL CONDITIONS
Desired Starting Date Es 'mated Time f Completion
Permit to be issued to '
the holder of Drain Layer's License No. G �j. 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
Licensed Drain 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 i e name of the Town of South Windsor:
Engineering Department Date
Connection Charge Paid Permit Fee: Paid $
Check Number
/ l,45 7,0,-)-�
Issued by
Tax Off is
INSPECTION
Date work started _ ¢' Date completed
Sufficient notification received: Yes No 9 1 �7--
Special Conditions
APPROVED:
Inspector pate
—]
Construction Inspection Report
• Project It b _.a pY A �69
St eel Time 9,�3
Uu PA ZOtey
Weather c o In
Developer Cont cforR
Work in Progr 17S
Problem Areas
Special Instructions/Orders