HomeMy WebLinkAboutDrain Layers Permit 93 Spinners Run TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMITNP 6003
I r 19
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
93 S�/N�CI�RS. UnJ at premises owned by :?A
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 (v)
INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with a
Show sketch of proposed work or furnish 'two (2:) copies of separate drawings.
OSHA REQUIREMENTS MUST BE FOLLOWED
f
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion Uf� y
Permit to be issued to L)A w k4A)
the holder of Drain Layer's License No. �, 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 Al r
Licensed rain�hayer
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: l
r
E g eer Dept . Date
Permit Fee Paid $ Check i Nu ber
Connection Charge Receipt No. 7j`�� �� Dated 5, q
� r
Issued b r
INSPECTION a,
Date work started �2 `3 Date completed
Sufficient notific—ation received:97 'yes No
Special Conditions
APPROVED: h�op
Inspector Date