HomeMy WebLinkAboutDrain Layers Permit Simcka Drive TOWN OF SOUTH WI N DSOR ,
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut '
DRAIN LAYER' S PERMIT N? 43
1t y4F^*,6ar/4i,. ) 19 69
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
Ay
the work indicated below at v y 04 kA q'#{t� ' *�, on the
side, betweec49!1i.'C0#gf" +�41%#4 44 it ,
at premises owned by!%/,V6a V1 a—
whose address is MO i Ia5r+ i. +ft &&Sl Mow r h � Zi3 --7,����
and to Lay House Drain, Repair House Drain, _It Lay Main, _X_OtherA*j%, &,,,Ny4`4^jj
for lees i lA0ol—O A♦,o occupancy or use,
with of 96 r 4 61 Family Units, with acres.
Type of Sewage to be connected under this permit:_
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made wit h#%ASS P 1 4g w o j y AL ASj t4 p,ort L gA"t 94 A 4..S.
Permit to be issued to trtsJO "A&tk%A.*I
the holder of Drain Layer's License No + 24 &4 0 . Permit will expire on*10%Tq Aj&L, j2 19"�,
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and thkf reverse side
thereof. Applicant has received Town Permit No. ZL402 and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS � �,w" ,,.rr � •
Signedi
—V-1,2-
Connection Charge Paid $ Licensed Drain er
(Sig) issued
Tax Collector
Permit Fee: Paid $ � ?
--T
INSPECT ON: lily
INITIAL ! t' (Sig)
FINAL (Sig)
APPROVED _ `' (Date)
(Sig)
INSP CTOR
+ 4 WA
Issued By• Town of South Windsor Date of Issue
Department of Public Work /D Zg-- 6
Permit No. PERMIT Date of Expiration
N° 2 0 3" i D -- ZO - 70
TYPE OF WORK TO BE DONE:
Location: Y
C7 �ort1 q Ie t Cim C YA DIP,
Connect with Storm Sewer . . . . ell
Placing Building Materials . . . . . . ❑
Excavate . . . . . . . . . . . . . . . . . . . ❑
Curb Cut . . . . . . . . . . . . . . . . . . . ❑
Construct Sidewalk . . . . . . . . . . . . ❑ CAvT-
Construct Curbing . . . . . . . . . . . . ❑ Description: S)}A4 S Q ePo'
Erect Sign . . . . . . . . . . . . . . . . . . ❑
Remove Stump . . . . . . . . . . . . . . . ❑
Transport Building . . . . . . . . . . . . ❑
Driveway Ramp . . . . . . . . . . . . . . kI
Misc. . . . . . . . . . . . . . . . . . . . . . . Fee $10.00 By !Bond f Amount
Work to be carried on according to the Regulations and By-Laws of the Town of South Windsor.
This Permit to be on the job at all times. Sidewalk should not be obstructed.
Name of Company Director of Public Works
(PRINT) Signed2L�
Sign Date Checked
((.PhoVINo.
Address lao �',^ S �70 OK By