HomeMy WebLinkAboutDrain Layers Permit 144 Rimfield Drive I
TOWN Of SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 8
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
t premi e. o�t d by �Y..•►.._
whose address is and to
Lay House Drain, Repaifr House Drain, Lay in, 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 furnish 'two (2) copies of separate drawings.
OSHA REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layers 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
Signed _
Lice s r Layer
The above n-amed Drain Layer has a valid. license .issu, d .by the State of
Connecticut and has filed a satisfactory bond -and insurance policy in the
name of the Town of `South Windsor
Engineering Dept. Date .
Permit Fee Paid Check Number-
Connection Charge Receipt No. 4TZ Dated
Issued by
INSPECTION
Date work started ""a`�g � Date completed g--p9 9g41 _ .
Sufficient notificat on receive a : es: No
Special Conditions
APPROVED:-- _
Inspector Date
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