HomeMy WebLinkAboutDrain Layers Permit 6 Drake Court Xt
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 5995
�P D i^Q,kQ, 9 Z_
• 19
Pursuant to written
application, permission is hereby granted to the
Licensed Drain Layer named h in to perform the work indicated below aj
A
�^�� at re ises owned by J YYI Cop,S 7.
whose addres is G SIla lzmS'a. o�Sov- an o
Lay House Drain, Repair Hdfise Drain, Lay Main, Other ,
for occupancy or use, with
r Family Units, w h acres. -'
Type of Sewage to be connected under this permit: SANITARY SEWAGE (
INDUSTRIAL WASTES ( ) , OR
Connection will be made with AR 4� PiJ i/
Show sketch of proposed work or furnish 'two (2) copies of separate drawings.
�i r%
SPECIAL CONDITIONS OSHA REQUIREMENTS MUST BE FOLLOWED
Desired Starting Date _Q'-i>_ Estimated Time for Completion
Permit to be issued to 3"Qh17
the holder of Drain Layer's 'License No. Zc2rg3p 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. /!
igned
Licens Drai ayes
The above named Drain Layer has a vali license issue by the State of
Connecticut and has filed a satisfactory bond and nsuran `e policy in the
name of the Town of South Windsor:
/fZ. ��
En ine'e ng Dept. Date
Permit Fee Paid $ L-�.1 �C)C) Chect umber ds
Connection Charge Receipt No. & 1 Dated 617_ e�
Issued by
;;4A
INSPECTION 7-7
Date work started Date completed
Sufficient notifica o- receivee : - 'yes No
Special Conditions
APPROVED: #£'
Inspector Date