HomeMy WebLinkAboutDrain Layers Permit 24 Rimfield Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL#13
DRAIN LAYER'S PERMIT `S-No 5706
*Z-,I— Z- �� , , 19 9 Z.__
ursuant to written application, permission is hereby granted to the
Li ens d Dr n r named herein to perform the work indicated below t
ki14N t /M Vr-1 at V
mises owned by ��Ca.,j1,
w ose address is f� � and to
Lay House Drain, Repair Ouse 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
Show sketch. of proposed work or fu nish two (2) copies of ;separate drawings.
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion-2 - )
Permit to be issued to
the holder of Drain Layer ' s License No. LapLlfZ_ .. 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 Ro.
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:
lit
Engineering ept. Date
- 4 ,Permit Fee Paid $ ,�-�---'GTieck Number
Connection Charge Receipt No. Dated
Issued by /✓ �
INSPECTION
Date work started (.% Date completed 2 �gZ
Sufficient notification rece ve : es No
Special Conditions
APPROVED:
Iihbpector Date