HomeMy WebLinkAboutDrain Layers Permit Lot 46 Rockwell Cour TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT t! 6013
Pursuant to written application ' 19 �3
Licen ed Drain ay, - name herei to ' permission is hereby granted to the
`j perform the work indicated below at
whose address is G at remise, o ned b
y
Lay House Drain, SRepair ouse Drainss�f
s. Lay Main, the
a to
for � �� occupancy or use, with
Family Units, /with //�/ i
—acres
Type of Sewage to be co 11 nnected- under this ermit:
INDUSTRIAL WASTES ( ) , OR p - SANLTARY SEWAGE
Connection,.. ( -
wi,l'1 be,_made with SDR 3 S
Show sketch of � p
pro osed � work or furnish 'two (2) copies of separate drawings.
OS A REQUIREMENTS MUST B POLL D
SPECIAL CONDITIONS
-�-�D r�c.,� sic /i
Desired Starting Date
Estimated Time for Completion 7 Permit to be issued to
the holder of Drain Layer 's License o..
(30) days after date of issuance. ? agt =�o '`, Permit will expire thirty
to all the terms and conditions setTforthdinstheed Drain Layer hereby agrees
thereof. Applicant has received Town Permit No, permit and the reverse 'side
CHD Permit . No, and/or
Signed
- �, Lie en rayin Layer
The above named Drain Layer has a valI license issued by the State of
Connecticut and has filed a satisfactor
name of the Town of South Windsor: y nd and surance policy in the
Permit Fee Paid E gin ng Dept. Date
Chec Number r �i
Connection Charge Receipt No. ,
— _Dated L)
Issued by 1-V
INSPECTION \
Date work started
Sufficient notifica" trecLve �: i3 Date completed 9- s_ 3
Special Conditions es No
APPROVED•___.�' D�c�/
Inspector Date