HomeMy WebLinkAboutDrain Layers Permit 79 Dower Road ..... 'OWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT ` N o 5819
A' , 19
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
71 `�j 6ari/=TZ / p at premises owned by 77M Si1,1 // R
whose address is 79f <-,?060�2. ,-;-v7- 5% w" N and to
Lay House Drain, >' Repair House Drain, Lay Main, Other ,
for NGc c_- r c Y -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 .
SPECIAL CONDITIONS
Desired Starting Date FIz z. Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer ' s License No. __V0 77,�-- 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 . ,V and/or
CHD Permit No .
Signed
g
Lice�ised 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 in the
name of the Town of South Windsor :
Engineering Dept . Date
Permit Fee Paid $ ,7 6--- Check Number 3J
Connection Charge Receipt No . .j Dated ' /,q'(7
Issued by
INSPECTION
Date work started 8 /?.� `OJ7/ / Date completed
Sufficient notification recel.ve : es No
Special Conditions
APPROVED:
Inspector Date
t
a ti
m 1540 SULLIVAN AVENUE SOUTH WINDSOR. CONN. 06074
SOR-c AREA CODE 203/644-25U
Fax.# - 203/644-3781
FACSIMILE MESSAGE TRANSMITTAL FORM
Date: August 17 , 1992
PLEASE DELIVER THE FOLLOWING PAGES TO:
NAME: Sandra Stolarz
ADDRESS:
FAX. # 243-7503
MESSAGE FROM:
NAME; Joyce
ADDRESS: Engineering Department
MESSAGE
Attached is a copy of our "Drain Layer' s Permit" taken out on
August 10, 1992 to connect 79 Dower Road to the Sanitary Sewer
System. Said connection was inspectEd,: by Town on August 12 , 1992.
All necessary fees have been paid.
NUMBER OF PAGES' TO FOLLOW: �_