HomeMy WebLinkAboutDrain Layers Permit 32 Sele Drive _ TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT .
Pursuant" to written application, permission is hereby granted .to .the
Lic nsedW Drain Layer named herein to perform the work ind ated b ow at
E i 14 at pr misas owned .by .. -ex co,
whose address is -7 y AAA 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 k) ,
INDUSTRIAL WASTES' ( ) , OR ( ) -
Connection will be made with L
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 S(4nF=1L CwJSZ: C4.
the holder of Drain Layer' s License No -ZA7'799 . 'Permit will expire thirty
(30) days after•,; date of issuance. The undersigned Drain Layer hereby agrees
to all the to ms and conditio s et . forth i th perm t and t, a reverse' side
thereof. h� r� edTow 'm "" an`d/or
CHD_ Permitr
• (} tj•_ l S inn e-d 1
Licensed Drain Layer
The above named Drai Layer has 'a v id license :issued by the State of
Connecticut and has filed a ' satisfactON b nd and insurance policy in .the
name of the Town of South Windsor:
o.r-'4-
E gi a in Dept: Date
Permit Fee Paid $ n'�Aj' 00 Chec Numbe Yt 110:: 419.9.
Connection Charge Receipt No. 2 . Dated '
Issued by (1�•�
INSPECTION -`
Date work started Q22L, Dat completed 0 6 -
Suf f ic.ient- notif icar o rece ~ e as _ No
Special Conditions
If Y
APPAtOVED:
nspecto'r Date