HomeMy WebLinkAboutDrain Layers Permit 110 Diane Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 5989
j
Q . 19
Pursuant to written application, permission is here y granted to the
Licensed Drain Layer named herein to perform the work indicated below at
at premises owned by
i
whose address is // O X,0, :.,., /4.,,_ adA to
Lay House Drain, X Repair House Drain, Lay Main, Other
for / � _ o 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 (2) copies of separate drawings.
1"
SPECIAL CONDITIONS
OSHA RE IREM TS MUST BEIPOLLOWED
j
Desired Starting Date :Z-.20 - .Estimated Time for Completions--
Permit, to be issued to L47-04. 1Pf-DE ,r a7h'ERS >�✓C�,
the holder of Drain Layer's License No. _Wc -s- 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.
l>
Signed
Licensed Dr in' LayG
The above named Drain Layer has a valid license issued by the State of
Connecticut and has filed a satisfactory bond and insurance policy in the
name .of the Town of South Windsor:
E gineering Dept. Date
Permit Fee Paid $ iJ Check Number
Connection Charge Receipt No. I3,41 Dated
Issued by
INSPECTION 2
Date work started `Z 20 -- 9/ Date completed
Sufficient notifica' ion'-'rece ve es No
Special Conditions
APPROVE3.
In p ctor Date