HomeMy WebLinkAboutDrain Layers Permit 60 Quail Run TOWN OF SOUTH Wl N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
0 5894
DRAIN LAYER'S PERMIT " o
60
Pursuant to wr t ten ap lion permission is hereby ranted P y g to the
Licensed Drain Layer named herein to perform the work indicated below t
;at premises owned b ��_ l��1 _T
whose add ess' is a-ph ao
Lay Howe Drab n, R'epai House' Drain, Lay in Other ,
for occupancy or use, with
Family Units, ith acres.
Type, of Sewage to be connected under this permit : SANITARY SEWAGE ( tlj',
INDUSTRIAL WASTES
Connection will be made with 2i,y
Show sketch of proposed wo-rk or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS,
Desired Starting Date / -- 73 Estimated Time for Completion f,p
Permit to be issued to 3G�hCl G C?11 �5
the holder of Drain Layer's License 1 o. gg3a . . Permit will expire thirty
(30) days after, date of issuance. The undersigned D.rain' Layer hereby agrees`
to all the terms a.nd .conditions set foxth in the permit and, the reverse side
thereof. Applicant has received Town Permit No., and/or
CHD Permit No.
Signed
L cen Dr i Layer
The above .named Drain. Layer has a vali 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:
017
Engineering Dept. Date
Permit Fee Paid $ 7/?''-.----�- Check. Number Al�
Connection Charge Receipt No., ?•► Dated
Issued- by
INSPECTION
Date work started Date completed
Sufficient notification r cceive�ia;Tes No
Special Conditions .
APP 1g3
Inspector Date