HomeMy WebLinkAboutDrain Layers Permit 8 Spinners Run TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 5975
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below ,at
- �41 4 a at premises owned by hPW L—' /P�2
whose address is and to
Lay House Drain, _Repair House Drain, Lay Main, Other
for 6 9/01944VA 4- occupancy or use, with 401V
Family Units, with acres.
Type of Sewage to be connected under this permit : SANITARY SEWAGE
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with yc--
Show sketch of proposed work or furnish 'two (2) copies of separate drawings:.
OSHA REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONS -
Desired Starting Date K . L 9_Estimated Time for Completion
Permit to be issued to ?'
the holder of Drain Layer's L cense No.;O- Permit will expire thirty
(30) days after date of issuance. The undersigned Drain Layer hereby agrees
to all the terms and conditions sei . forth in the permit and the reverse side
thereof. Applicant has received Town Permit No, and/or`
CHD Permit No. �..
Sig
Li need Drain Layer
The above named Drain Layer has a valid lic nse -issued ''by the State of
Connecticut and has 'filed a satisfactory bond and insurance policy in the
name of the Town of South Windsor:
n in ng Dept. Date
Permit Fee Paid $ L��-oo Check Number
Connection Charge Receipt No. 4-:�, 60 Dated AN l7
Issued by �.
INSPECTION
Date- work started V�r Date completed
Sufficient motifica on rece v -Yes No
Special Conditions
AP P RO V
I7hspector Date
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