HomeMy WebLinkAboutDrain Layers Permit 1001 Foster Street = TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 6000
19
Pursuant to written application, permission is hereby grant d to the
Licensed Drain La r najned hnei to perform the work indicated below a
�( , at premises owned by
whose add ess is U ,._ T ��-- and to
Lay House Drain, Repair House Drain, Lay Main, Other ,
for 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 or upL i
j,W ty9-(Ga p
2 copies of separate drawings.
cr✓60
SPECIAL gpND S OSH REQUIREMENTS MUST EJOLLOWED
ITIO
Desired Starting Date / 4 I/ s.tim d'Time for Completion
Permit to be is$iied to v .<A-A
931vu r
the holder of Drairkayer's License No. Permit will expire thirty
(3-0). days after Ajaive of issuance. h'ndersigned Drain Layer hereby agrees
to all the termsand conditions set th in the permit nd the everse side
thereof . Applicant has received To Permit No. A 11i /)a /or
CHD Permit No. 2 33 a 1 f
Signed
L ensed, Drarb
y/e�
The above named Dr4L Layer has a valid li nse issuedhe 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 Check Number
Connection Charge Receipt No. Dated
--=/ - -— Issued-by _- - -- -- -
INSPECTION
Date work started =2IL r9 Date completed
S_if f.i.t ien,t--n-o-tificarl.5-ram-e--ve - :: - es - - -No --- -- -- --- -
Special Conditions �--� �`~
0
APPROVE err-
Ins ector Date