HomeMy WebLinkAboutDrain Layers Permit 27 Sunnyside Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC CODES
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 540
Pursuant to written application, permission Is hereby granted to the Llc sed Drain Layer
Round herein to perform cM1 work indicated below at �' 7 r�Lay, , a, _
at premises road by ( _ /�/(//y p�V- wRose address is
2 � S1,.,> >. .i—Z and to
Lay Novae ➢z ini ) ,/� Repair house Drain. Lay Main. Otte- ��L. �
for occupancy o[ e. with
family Unite. witM1 tea. o[ s. J
Type of Sawage to be connected under this permit: SANITARY SEWAGEu(i). IN➢USTRIAL
WASTES ( ) . OR ( ) Connection will be made with
Show sketch of proposed,work or furnish two (R) copies of separate drawings.
I
SPECIAL: COflMITIONS — --
Desired Starting Date $ /J 0 Estlmaoed Time for Completion fS l)
Permit to be issued oo ` tp �"i.� vA/(�
the holder of Drain Layer a LLcevee No. o' "�. Pexmrt will exp4e thirty (30) days
after date of issuance. The undersigned Drain Layer hereby agrees All tfia terms and
conditions set forth in [he pexafc and the reverse aide thereof. %pP ha received
Torn Permit No, and/or CIE) Permit No.e
Signed
LICamea ore � r
The above named Drain Layer has a valid license issued by [he State bf"connecticut and
has filed a satisfactory bond and Insurance policy in the name of the Town of South Windsor:
/rZ/ i> �/-�d
Engineering Department Date
CovvecYlon Charge Paid VW Permit Pee: Paid $
Check Number
Issued by
Tax Office
INSPECTION
Date work started pate completed
Sufficient notification received: Yes _ No
Special Conditions
APPROVED:
Inapececr pace
_ ozcS4'89
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: G/;6I [V ek h
BUILDING ADDRESS OR LOT Ne : �^Z) TT�j
STREET: 'loywl SI(I? UL
SUBDIVISION: ]]
� AN STATION : _+.
NORTH ARROW l4- INVERTELEV:
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LTEflLL G R4l ROUSE CO STUB 9TYB (, COXNECTIOSr '! J . FT.
LEV. INVELEV. INV. ELEV. ANLA *' BUILDING
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(IFE ISLI
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W STATION :!L+_r'I
INVERTELEV: ;Q3 K9
CouFr\ c6nS�-: �btiws
CONTRACTOR (PRINT)
NA TOR' 8V ERVISOR(PRINT)�
STREET ADDRESS SIGNATURE 'V . DATE
TOWN Win�.SDR STATE�E ZIP �GT DATEO
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c > 444/ 3C)31
TELEPHONE NUMBER
WHRE - TOWN PINK - CONTRACTOR YELLOW -CONSULTING ENGINEER/DEVELOPER