HomeMy WebLinkAboutDrain Layers Permit 595 Nutmeg Road r .: ....,.:., .:..^.. ,...,. ....: _. _. ..., :a ., ..e., .n� ..rw•c':+- -..a.-.tea.
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
\ BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 'S 5 354
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer
named herein to perform the work indicated below at - -
s'9.�
at premises ovine by Uwhose address is
and to
Lay House Drain, Repair House Drain, Lay Main, Other
for (' 7/2f�CJGG/ — occupancy or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (�G}, INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separ a draw' gps. ;
G�,✓'rr� i V �
ilM
SPECIAL CONDITIONS � \�
Desired Starting Date /Q- / Estimated Time for Completion O - /2
Permit to be issued to �� - �5 7- �,
the holder of Drain Layer's License No. ��,6 Y . Permit will expire thirty (00) ys
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. A ic�a�t has received
Town Permit No. and/or CHD Permit No. �i ;
Signed �- - ,'� C
Licensed ain 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
Connection Charge Paid Permit Fee: Paid $ P 5.C',
Check Number iQ h t
Issued by
Tax Office
INSPECTION O
Date work started Date completed z..
Sufficient notification r eiv- . — Yes No
Special Conditions
APPROVED:
Inspector We
Construction Inspection
Report
/ V1
9 ' ,
Work inProOess
did
A.pqjjlll
�I/ Ott_ i r i
1
i
1 1 1
Construction Inspection Report
• Project Dad s �,
Street Ti e / ; 3 �
t7 0
Weather o In
Developer -� C roclor���
Work in Progress 6 'ow
c R
Problem Areas
Special Instructions/Orders