HomeMy WebLinkAboutDrain Layers Permit 126 Quarry Brook Dri TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT � �9. 471.9
of�Y 19
Pursuant to written application, permission is he by r nted to the Licensed Drai ayer
named herein to. perform the indicated below at
at premises owned by g, 2-0
t��
hose address "is
La House Drain and to
y , Repair House Drain, Lay Main, Other
for
Family Units, with acres. occupancy or use, with
Type of Sewage to be connected under this permit: SANITARY SEeME ( ), INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to i l�iytn Qw J G
s License No._?()' P
the holder of Drain Layer' ermit will expire thirty (30) days
after date of issuance. The undersigned Drain La er 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.
Sign�d
LicensedFDainaye�r ��
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:
Enginee ing Department Date
Connection Charge Paid /G'7i~ ��G Permit Fee: Paid $ h
74-p
Check Number A
i
Issued by (i-
Tax �3ffice ,
INSPECTION
Date work started ��^ / Date completed �' o' J
Sufficient notification received: Yes No
Special Conditions
APPROVED: _ �� F -7
insp&dtor Date
S6/os3
µousc # t z9
v -
c
7, ;
2_. TF F/- - /) 77
k �
L1 r Kn .•/ f �
7' L/ l�n,` r-r ' G. Ski 7
\ L 5.1
171
r--
,r
cory'v. I HEREBY CERTIFY THIS PLAN MYRON FEINSTEIN ASSOCIATES
�4 oN MA' r��.r TO BE SUBSTANTIALLY CORRECT ; LAND SURVEYING 9 LAND PLANNING;
Cos t C. ENGINEERING
WEST HARTFORD CONNECTICUT
No.Sul
4�clSTE '° �/ _' SCALE DATE REVISED COMM. 1rq,
SUIN
ram' �l