HomeMy WebLinkAboutDrain Layers Permit 30 Spinners Run TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMITNr 6027
Pursuant to wri ten application, permission is hereby granted to the
L ' ensed Drain Layer named erein to perform the work indicated bel9vsit
r- at premises owned by 1/AK
whose address i and tq
Lay House Drain, ��Repair House Drain, Lay Main, Other ,
for occupancy or use, with 0C
Family Units, with acres.
Type of Sewage to be connected under this permit : SANITARY SEWAGE
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with L' e_-_
Show sketch of proposed work or furnish 'two (2) copies of separate drawings
SPECIAL CONDITIONS OSHA REQUIREMENTS MUST BE FOLLOWED
Desired Starting Date Estimated Time for. Completion 4--7el- .5 Z
Permit to be issued to
the holder of Drain Layer's License No. oP y z • Permit will expire thirty
(30) 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. �
Signed /
Licensed Drain Layer
The above named Drain Layer has a valid license issued by the State of
Connecticut and has filed a satisfactory bond and insurance policy in the
name of the Town of South Windsor:
I I: ? Rohe
En i eer Dept. Date '
Permit Fee Paid $ Check N er 00�' L
Connection Charge Receipt No. 4---5 7 7 Dated
Issued by
INSPECTION
Date work started O �Z,7'13 / Date completed /p -zS-53
Sufficient notificaF on rece ve : Yes No
Special Conditions
APPROVED: A517
Inspector Date