HomeMy WebLinkAboutDrain Layers Permit 74 Rimfield Drive s
TOWN OF SOUTH WI N DSOR
Q DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT '.NO 5807.
s-� 19 y2-
Pursuant to written application, .permission is her by granted to the
Licensed rain Layer n me;d. herein to perform the work indicated below t
-j-�`,4�f S 2 e- 1 J at pr mise o ned by �� 14,T' G61,1 S .
whose address s 5" , , and o
Lay House Drain, Repair Ho se Drain, Lay .Main,
Main, Other ,
for 1. occupancy or use, with ;e
Family Units, with acres. i
Type of Sewage to be connected under :this permit: SANITARY SEWAGE
INDUSTRIAL WASTES ( ) , �OR ( )
Connection will, be made with
42
Show sketch of proposed.,work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS Q � S
Desired Starting ,Date Estimated Time for Completion j>
Permit to be issued o
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 ppymit and the reverse side
thereof. Applicant has received Town Permit No . and/or
CHD Permit No,
...mow.-•+.. .tu.. .,I..�.,.:�� '.",. '. -
Signed
16ensed rain aver.
The above named Drain Layer has a vapid Oicense issued by the State of
Connecticut and has filed a satisfactory bond and insurance policy in the
name of the Town of South Windsor:
f > Engineering Dept.: Date
Permit Fee Paid $ r,`j. Check Number 9-l0
Connection Charge Receipt No. 9 Dated
Issued by
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date