HomeMy WebLinkAboutDrain Layers Permit 23 Rimfield Drive f TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL nn c
DRAIN LAYER'S PERMIT A +No 5705
19
Pursuant to written application, permission is hereby granted to the
Licensel Dra w}� Layer named herein to perform the work indicated belo at
c, l�, O � t premises owned by � C�s�
whose address is Sr and to -
Lay House Drain, Repaik House Drain, Lay Main, Other ,
for 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 17V
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting' Date Estimated ime for Completion L . 7, 2.--
Permit to be issued to =,O /G`�
the holder of Drain Layer's License No. 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
thereof. Applicant has received Town Permit No. and/or
CHD Permit No.
Signed
Licensed 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: jjA
E 'nee g Dept. Date
Permit Fee Paid $ Check u ber IU 4'7�
Connection Charge Receipt No. 12-, Dated Zflof�}Z
Issued by
INSPECTION
Date work started " — Date completed .7- 7-0 �
Sufficient notification re e ved: _ es No
Special Conditions
09
APP
Inspector
I