HomeMy WebLinkAboutDrain Layers Permit 114 Rimfield Drive 7 7-
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL p C
w� DRAIN LAYER'S PERMIT i 2N� 5 8`�3
1
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Pursuant to written application, ,permission is hereby granted to the
Licensed Drain Layer named herein to y perform the work indicated - below at
Zo � V >.of remises owned by S S�/�5 74
whose address i a to
Lay House Drain, Repair ouse Drain, Lay Main, Oth r ,
for pwn/ oc.cupancy or use, with j ,e
Family Unit , with y acres .
Type of Sewage to be connected under this permit : SANITARY SEWAGE
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with S' 3Ccc� eY
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS OJ / A 7,1/ S. Y4GJ lec:51� /0 V 16
Desired Starting Date Estimated Time- for Completion . r
Permit to be issued to
the holder of Drain Lay er's _. _ cense 6 Permit will expire thirty. ,
(30) days after date of issuance. T e undersigned Drain Layer hereby agrees
to 411 the term.s . and conditions set forth in the permit nd the reverse side
thereof. A-pp idant has received Town Permit No . 44d-.for
CHD-Permit N'o.
Signed
Li a sed ain 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 :
c��-e z
Engi 4ering Dept. Date
Permit Fee Paid $ Check Number is
Connection Charge Receipt No. --=� � Dated
Issued by ����..5~ 92-
INSPECTION
Date work started 97— Date completed
Sufficient notific—a on receive es No
Special Conditions
APPROV
Inspector Date