HomeMy WebLinkAboutDrain Layers Permit 120 Rimfield Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
�`� BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT o 5 Q 217,
19/
Pursuant to written application, permission s hereby granted to the
. Licensed Drain Layer n ¢ d herein to perform the work indica e ,K belo�? ate.
i at .p ;e ises Wne by
w ose address is r r" fd and to
Lay House Dra , 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 ii!
Show sketch of proposed work or furnish two (2) copies of separate drawings.-,,
SPECIAL CONDITIONS �' j/1( JAI
Desired Starting Date 1 timated Time: f or._ Completion
Permit to be issue'
the holder of Drain L,a er"s License No. IS� Permit will- expire thirty
0.0) days after date of issuance. The undersigned Drain. Layer her agrees
to all the terms;. and conditions set fo�rFti ,nt �jthe per it a dy the reverse, side
thereof. Applicant has received 'Town4iP rmit` No. ' ��(e��` and./or
CHD Permit No.
Signed'`
icenq,.ed ra irylltaver
The above named Drain Layer has a valid icense is ued y the State of
Connecticut and has filed a �satisfactory bond and insurance policy in the :
name of the Town of South Windsor: '
E giri,a ing Dept. Date-
Permit Fee Paid $ jj� v� C h e k umber,,, L
Connection Charge Receipt No. �,/, c6n- Dated
Issued by 81 /b9
INSPECTION
Date work started 6 Zx/ 37 Date com;#Ieted
. Sufficient notification r ce ve : yes No
Special Conditions
APPROVED`:
Inspector Date -