HomeMy WebLinkAboutDrain Layers Permit 56 Breezy Hill Drive TOWN OF SOUTH WINDSOR
-DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT :a
19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform the work indicated be ow at
at premises owned by f-� e � i- --------
—I ig 04 whose address is
La House Drain and to
y , Repair House Drain, Lay Main, Other
for
occupancy or use, with
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 proposed work or furnish two �i) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date Z� �g=No
Es;Layer
ed T' a for Completion z s ,Permit to be issued to the holder of Drain La er's Lice e .yPermit will expire thirty (30) days
after date of issuance. The undersigned rain hereby agrees to all the terms and
conditions set forth in the permit and the reverse side thereof., A p I ant h s received
Town Permit No. and/or CHD Permit No. f
Signed
is , 'ed Dr n Layer
The above named Drain Layer has a valid license issued by the S � Connecticut and
has filed a satisfactory bond and insurance policy in the name of theown of South Windsor:
�1
Engineering Department Date
Connection Charge Paid Permit Fee: Paid $ /`7�6)v
Check Number J ��
i
Issued by
Tax Office
INSPECTION
Date work started Z-3 - Date completed - 2-3--99
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date_
Construction Project Inspection Report
•
Date
Sfreet L _L:;_
Time
Weather /0" -v
O o� Ins .
Developer Con cfor
P'i-L r
Work in Pro ess
•
Problem Areas
Special Instructions/Orders
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