HomeMy WebLinkAboutDrain Layers Permit 338 Burnham Street DRAIN LAYER'S PERMIT APPLICATION NO.
THE METROPOLITAN DISTRICT
BUREAU OF PUBLIC WORKS099427
w 555 Main St.,P.O.Box 800,Hartford,CT 06101 'aa4, 1 lg
ACCT NO.
The undersigned agrees to perform under ordinances the work indicated
below at 3JQ— jNjVJ LEE r Lot M o
on the side',in the town of S D•l nj i , r'onn.
a between Z26
at premises owned by d�of 44, -S-u a awP.�t
E whose address is en xgi-a 49_
NATURE OF WORK: R House Conn; ❑Lot Drain, Catch Basin; ❑Main Sewer;
New; ❑Repair; ❑-Bulkhead; ❑Utility Drain; ❑
OCCUPANCY OR USE: Epesidential with ai4 Family Units;
❑Commercial; ❑Industrial; ❑
' Public Sewer or Drain is: SANITARY; ❑STORM; ❑COMBINED.
ONLY the following SEWAGE or DRAINAGE is allowed to this connection:
c_ Q SANITARY SEWAGE; ❑INDUSTRIAL WASTES, as approved , 19_
F TORM DRAINAGE including surface and sub-soil water;
Connection will be made with
Located
i €-o a
SPECIAL CONDITIONS -
� is�`rt a a +sr--9���- # i3 1'1 � ��� �•i �: `d ��"�' k U+t.; 4i�.�s -�
i�Town-Cit ermit No. and CHD Permit No. for street excavation
j Sewer Tributary to a _W.P.C. Plant Insurance expires P_ate;19
Data from i•:A rg Plan Permit will expire on - 11n' 19-2 L
Dr. Sh. Required plans, submitted, approved by
Contract # Main Sewer Approved for H.C.'s.
y Area& f a =, Permit Issued by
s
Permit to be issued to the holder of
�. Met. Dist. License No. Signed: by r
State License No. 1 1
FIRST INSPECTION: FINAL INSPECTION:
Called M. , 19_ Called M. 19—
g T_ :Insp. M. , 19_ To Insp. M. ,, 19_
FINAL INSPECTION APPROVED on , 19_
by