HomeMy WebLinkAboutDrain Layers Permit 90 Scantic Meadow Ro TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT N2 5168
19
Pursuant to written application, permission is hereby granted to the L" ensed Drain L yer
named herein to perform work indicated below at �� ���� �
at premises owned by � whose address is
and to
Lay House Drain, Repair House Drain, Lay 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
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer's License No. LO8 gn.S Permit will expire thirty (3O) 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 CHD Permit No.
Signe
tname
icensed ra n Layer
The above named Drain Layer has a valid lice se sshe State Connecticut and
has filed a satisfactory bond and insurance policy ' thf the Town of South Windsor:
A3
/} 0--30—��
& 7 Engi eering Department Date
Connection Charge Paid
g Permit Fee: Paid $
P?/ Check Number
Issued by
Tax Office
INSPECTION
Date work started `� 2ti Date completed
Sufficient notif ication received: Yes No
Special Conditions
APPROVED:
Inspector Date
Field
INDUSTRIES P.O. Box 307,WAUREGAN, CT 06387
1.800-962-7473
-->c ��� A(
�CLvt of.Z Ox
eOtle-
6
Field Concrete Pipe Co.•Field New Hampshire
Field Precast Corp • Field Rhode Island