HomeMy WebLinkAboutDrain Layers Permit 159 Kelly Road a
Ong TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT N2 5936
19
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
/S9 1-`1 A.P at premises owned by /lid A7z/D 1,-4z/,o
whose address is is9 lfEz�S/ �D S• wiAJX> and to
Lay House Drain, __Repair House Drain, Lay Main, Other ,
for ,2i061e AAAli-/ 7Zeay gicc- occupancy or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit : SANITARY SEWAGE VQ ,
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with +�p�
Show sketch of proposed work or furnish 'two 2 co of se( ) copies P bra, a draw gs.
D
OSHA REQUIREMENTS MUST. B 'FOLLOWED
SPECIAL CONDITIONS
Desired Starting Date Estimated Time forCompletion,_
Permit to be issued to f, /?JT 1 6u91(_k
the holder of Drain Layer's ,License No. 2,t . • Permit will expire thirty
(30) days after date of issuance. The ��4- Igned Drain Layer hereby agrees
to all the terms and conditions set . foi h" in the permit and the reverse side
thereof. Applicant has received,-. Tp#4n ermit No. 17 .4 and/or
CHD Permit No.
Signed
Li erased Drain Layer
The above named AXain Layer has a valid license issued by the State of
Connecticut and has, f {led a satisfactory bond and insurance policy in the
name .of the Town 'of South Windsor:
n ine g Dept . Date
Permit Fee Paid $ n�,`� Q0.Sh Check umber —
Connection Charge Receipt No. 14I_:P)0� Dated
Issued by W 4- ?, 9
INSPECTION
Date work started Date completedj �•
Sufficient notifica on ce v es g
No
Special Conditions ' IAG AA III
`
APPROVE 7/3-93
Iffispector Date