HomeMy WebLinkAboutDrain Layers Permit 1340 John Fitch Boul r _ , TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT NO 831
4— 1 4/75 119
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 1340 John Fitch Blvd, on the
side, between
at premises owned by ''
whose address is
and to X Lay House Drain, Repair House Drain, Lay Main, Other
for Commercial occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with Six Inch Plastic ki ta•
Permit to be issued to Jnhs A. T.ramagne
the holder of Drain Layer's License No. N-9 206/38 Permit will expire on 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS _HighW&Y Cut Permit it 55
Signed
Connection Charge Paid 764 Licensed Drain Layer
Issued by Frsai: J.• ►spit}:
Tax Collector
Permit Fee: Paid $ ___ 25*00
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
' BOND TOWN OF SOUTH WINDSOR
Am It -Req. Art . PUBLIC WORKS DEPARTMENT Date 1-i
MUNICIPAL BUILDING —TIT—
Am't on File 1540 SULLIVAN AVENUE Permit No. 5 5
SOUTH WINDSOR, CONNECTICUT ,
Date of Expiration Permit Expires
APPLICATION FOR PERMIT
FEE $10.00 FK P, ( Sew t Y9� 1147
Name and address of applicant CaIIS7 Phone No. 's�.2 , S—22-
Location of proposed work s �5 Jy-Cy �• �• i>t/r`Pdt�a®� GJi✓ir/
Describe fully nature of permit requested A5. 'f i i'T-
Insurance on file with Town e. no Date policy expires
Name of Insurer %ydrigkt 4.u,i d -rIvr.
O Approximate time for completion y_ ?o _ Desired starting date 4/ 75
c�
U Show sketch of proposed work or furnish 2 copies of separate drawings
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I agree to furnish to the Town of South Windsor the amount of bond or deposit required and to
reimburse the Town of South Windsor for any expenses incurred by the Town for maintenance or repair
work in connection with this permit and that I am familiar with and will abide by the rules and
regulations for permits as outlined in the Town of South Windsor's (Pavement Cut Regulations.)
Signed ,L,�,, ,� ,
APPROVED: DATE APPROVED: L,� % DATEi���, 75—
Supt. of Highways Town Engineer
FOR INSPECTOR: Date work started Date completed
Sufficient notification received: yes no Type of repair: Perm. Temp p.
Unusual conditions encountered
Material slips attached: yes no Dated for Permanent repair
Signed
Inspector