HomeMy WebLinkAboutDrain Layers Permit 58 Ridgefield Drive TOWN 'OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT N2 5993
Pursuant to written a plication, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
•Ldt,4'? at/premises owned by
whose address is __and to
Lay House Drain, x 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 SEWAGE
INDATRIAL WASTES ( ) , OR (
Connection will be made with PVC,.
Show sketch of proposed work or furnish 'two (2) copies of separate drawings.
N
SPECIAL CONDITIONS
OSHA REQUIREMENTS MUST BE FOLLOWED �` '� :70V731ell
' ".
Desired Starting Date Estimated Time for Completion
Permit. to be issued tor,50-"
rar C C'C O
the holder of Drain Layer's License No. PerkYt will expire irty .
(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`
thereof. Applicant has received Town Permit No. -and/or
CHD Permit No.
Signed
Lice sed DrwP6 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
inef ng Dept. Date
Permit Fee Paid, $ ZY-(X) Checkn mber {V
Connection Charge Receipt No. 4() 1Dated 7- /J
Issued by
INSPECTION
Date work started 3'9 Date completed S d -93
Sufficient notifica on eceive es No
Special Conditions
APPROV
Inspector Date