HomeMy WebLinkAboutDrain Layers Permit 388 Strong Road TOWN OF ' SOUTH WINDSOR
DEPARTMENT OF`PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT _ F ?^ k,
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Pursuant to written application, permission is here ted o the Licensed rain Layer
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named herein to perform thepwork i icat;�d b.elo tom '
at premises owned by ` :. ` . pi.u, _ who a address is
and to
Lay House Drain, Repair House Drain,'' Lay Main, �`' Other ,
for occupancy or use, with
Family Units, with acres.
Type f Sewage to be connected under this permit: SANITARY SEWAGE ( ), INDUSTRIAL
WASTES ), OR ( ) Connection will be made wi
Show sketch of proposed�wo k or furnish two (2) copies of separate drawings.
M,{Ec
D K
SPECI CONDITION
Desired Starting Date Estimated Time for Completion
Permit to be issued to '��
the holder of Drain Layer's License No. Permit wil xpire thirty (30) days
after date of issuance. The undersigned Drain Layer hereby agre 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 '
(ter Xiciinsed 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:
Engineering Department Date
Connection Charge Paid Permit Fee: Paid $
Check Number ZA123
Issued by
Tax office
INSPECTION
Date work started Date completed
Sufficient notification received: tZ Yes No
Special Conditions
APPROVED:
pa e
Inspector
STANDAR
2. OF NI
SOU
PRACTICE
OTHER W
APPURTE
3. CEELEVE
RLI
FIELD
4. TEES/WY
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SUBURBAN PRINTERS
W *'388 *4/O if4W
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83.19 I 84.7
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! m m FUTUR EXTE NSiON — _
w — — — WATER MAIN
EX/ST/NO /2
N
Po _ PROPOSED
M.H.
— — SAN• 3
00-
RO S g"SANITARY SEWER® — 5 OFF
EXT CURBLINE (TYPICAL CL 9P'w2629A q:74.45
PAOEL) 2s _� v410Al
PROPOS ROAD
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PRoAoSEDA.AI G� oR T.F.=B.'3
SRN. M.. / l ONG132
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T.F.-82.00= L� T S/LL ELE/!
g: 72.31 Z S 8S D9
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