HomeMy WebLinkAboutDrain Layers Permit 518 Quarry Brook Dri TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 2 5916
518 �j ,tGLrry Bn.�oK.. Dr- -346/ - 1
19 �13
Pursuant to written application, permission is hereby granted to the
icensed Dr in Layer\ named herein to perform the work indicated below at
hwoc�1. at premises owned by Z ns/
A co .
whose address is �`7����pS F/ and to
Lay House Drain, ' Repair House Drain_ Lay Main Otfi-e L
.
for r— 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 L
Show sketch of proposed work or furnish 'two (2) copies of separate drawings.
SPECIAL CONDITIONS OSHA REQUIREMENTS MUST BE FOLLOWED
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License Njo. 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
tlEteof. Applicant has received Town Permit No. and/or
CI1 ?ermit No.
Signed
Licens 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 Dept. Date
Permit Fee Paid $ ,Q<`j .Oy Check Number caztl
Connection Charge Receipt No. Aicq- - Dated I �
Issued by
INSPECTION
Date work started ?r,'� =2 3 Date completed
Sufficient notif icaz on rev��_�T—yes No
Special Conditions
AP -'
Inspector Date