HomeMy WebLinkAboutDrain Layers Permit 181 Kent Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
C�� DRAIN LAYER'S PERMIT 30
19
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at,
at premises owned by 'O�C;s
whose address is f — and
Lay House Drain, X Repair House Drain, Lay Main, Other ,
for occupancy or use, with I
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.
OSHA REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONS
Desired Starting Date / Estimated Time for Completion
c
Permit to be issued to 7,4rhrcy >SX O Cear9e /:hp///&
the holder of Drain Layer' s Lic nse No, 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. l"y.72t7 13 •
Signed �. 2 ...:.� it. Gil
Lic .n 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:
-�7
Eng, neering . Dept. Date
Permit Fee Paid $ 2111 Check Number
Connection Charge Receipt No. h��/,f�x Dated
Issued by
INSPECTION
Date work started —Fe y-�'t� ; Date completed 6-tP9 -941
Sufficient notification receiveea:: Yes No
Special Conditions
APPROVED: 166�
Inspect � Date