HomeMy WebLinkAboutDrain Layers Permit South Windsor High S 1
TOWN Of SOUTH WI N DSOR
a DEPARTMENT OF 1PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT � 5471
ti/GIL/ 1 , 1990
Pursuant to written application, permission is hereby &ranted to the Licens-4 Drain Layer
named herein to perform the work indicated below at
at premises owned by -7-tf (J of 5-,pk7-1y WIVO whose address is
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 work or furnish two (2) copies of separate draw'ngs•
N�✓�Rs R D
VZ
h SPACIAL CONDITIONS S'GGf 7}} WflI_Ik'OR )4 f 6 7""
Desired Starpin.g,, � J- Vjf. 11770 Estimated Time for Completion
F�.
Permit to be issued to Fy;,�_�', CdAAS,"%yc
the holder of Drain Layer's License No. f►�-�J6�q y9 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.
A
Signed
,:''Licensed Drain 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:
Engineering Department Date
f
Connection Charge Paid Permit Fee• 'Paid $ IVIA
Check Number
Issued by k
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector pate
t
i
MATCH LINE-B Applicant:
i, I See Dwg.L-3
- ---•----•�— i-- Town of South Windsor
Board of Education
Uiii � t II 1737 Main Street
` .3
South Windsor Ct. 06074
SAN MH #
Superintendent
Dr. Joseph Wood
I ,�1.����. 528-9711
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3 o o J.
BENCH MARK # 5
storage Area No. 2 q I ,. Mx
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