HomeMy WebLinkAboutDrain Layers Permit 080 Cambridge Drive TOWN OF SOUTH WINDSOR
V DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMITG 5836
0 19
Pursuant to written application, Permission is fie/.by'y granted to the
Licensed Drain Laye n: ';,ed h rein . to perform the work indicated below 1 at
at remises owne by T <ati ST, c D.
whose address . is - -
;� S'Q�' and... to
Lay House Drain, Repair ouse' Dr-ain., Lay Main, Other ,
for :4/ o'c.cupancy or use, with
Family Units ,. w t acres.-
Type of Sewage o be connected under this .permit: SANITARY SEWAGE
INDUSTRIAL WASTES . ( ) . OR., (. )
Connection will be made withf, /`
Show .sketch of proposed ' or.k or furnish two (2} copi;. s' of separate drawings.
SPECIAL CONDITIONS B G
c
Desired Starting Date Estimated Time for Completion
Permit. to be issued to ID
the holder of Drain Layer's ce s ?.. Permit wi_11 exp`i.r,e thirty
(30) ;days after date of iss a;ice` a undersigned Drain Layer hereby agrees
to all the terms and conditi-ons .set forth in the permit and the reverse side
thereof. Applicant has rerceived Town. Permit No ` and/ore,
CHD Permit No
Signed
Lice ed 'Dr in Layer,
The above named Drain. Layer has . a val license iss> ed by the State of `'
Connecticut and has filed a satisfactory bond and insurance policy in the
name of the Town of South <Windsor : q
Engineering Dept. Date
Permit Fee Paid $ i�'"1 Check Number , �J -
Connection Charge Receipt No. 2�S"�/ Dated
Issued by
INSPECTION
Date work started 'Z y Date completed
Sufficient notificatlon receive v yes No
Special Conditions7Z?' •9is /�/— /��I,y G
APPROVED:
Inspector - Date
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