HomeMy WebLinkAboutDrain Layers Permit 159 Palmer Drive -
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL Owl',
: - 5884
DRAIN LAYER'S PERMI` 'Nco
19
Pursuant to.. written application, p'erm,ission is -sere y g anted to the
Licensed Drain Layer named herein to , perform th.e work indicated below at
C,c 2 at premis s owned y by ,cZ�A9.,_Sc I J r A1
whose address is, ( / and to
Lay House Drain, � ' epasr Hquse" `Drain, Lay Main, Other
for occupancy or usd', with
Family Units, with ,< acrfs..
Type of Sewage to be connected under this Permit : SANITARY SEWAGE
INDUSTRIAL WASTES , ( ) q OR
Connection will be made with
Show sketch of proposed work/ or furnish two (2) copies of separate drawings.
low
SPECIAL CONDITIONS_oe
L„ri►yf9
. ---
Desired Starting D' te ,ry / 171ya Estimated Time for Comet.ion
Per t,,o be issued to . d < 2 gT
the holder, of' ,Dr`a n Layer's License No. erm t w T expire thirty
(30)-:days after date .of issuance. The unders .gned Drain Layer he by agrees ^
to, all the tents and • co i �i�o�� set forth in .the. permit dfie- erse side
thereof. Applic*nt �{ ire e3ved Town Permit .N and;/or `
-CHD Permit No ..
S i g n e
is nsed: D Layer
The above named 'D-rain Layer has a valid icense is, d by the State of:
Connecticut and has filed a sat'isfactory .bond . and insurance policy in the
name of' the Torten of South Windsor :
En veering Dept. Date'
Permit Fee Paid Check Nu ben C
Connection Charge Receipt No. Dated \"'`
Issued by
INSPECTION
Date work started Date completed - '7 -.g
sufficient notification on M. ce a es No
Spec'ial 'Conditions
APPROVE 1�1?7
ns ector Date .