HomeMy WebLinkAboutDrain Layers Permit 33 Alison Drive ,-y,k-t -4,s." $,?1«S��M1'^[f r.r. �'.e'f.y+X"`.' -r.`r ?€iTxri•.xa" " .`f' x; - y a
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT S 8_
Pursuant to written application, permission is here y gra <ted 'to the
Licensed D in Layer named herein to perform the work ind cated' below at
OA x— at premises. owned by N
whose address is 11\Z 7 , A I so,,,, a/z_ and to
Lay House Draino �*T" 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
INDUSTRIAL WASTES ( ) . OR ( )
Connection will be made with
Show sketch of proposed work or furnish 'two (2) copies of separate- drawings.
t
HA REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONS
Desired Starting Date , Estimated Time for Completion
Permit to be issued to .�;�,�i
the holder of Drain Layer 's License No. a67.9s 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. andl,or
CHD Permit No.
Signed _V1.4JOU ' '
c ns Dr i Layer
The above .named Drain Layer has a valid 1 tense is ue by the State of
Connecticut and has filed a satisfactor bond and insura ce' policy in the
name of the Town of South Windsor: q
ngi ring` Dept. Date
Permit Fee Paid $ . � • Uc� Che Number CQ�3
Connection Charge Receipt No. 44.q 9 Dated q._k
Issued by / L
INSPECTION
Date work started r'is' 9-r Date completed _19.x qke"
. -Sufficient notification rece ve : es No
Special Conditions
APPROVED:
Inspector Date
` 3 �+ *
S
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: TIME:
BY: «\Vve FOR LOCATION: aj�j � atti \v
DAY INSPEC. NEEDED "A (fYAor�) TIME: q- q.n
TYPE OF INSPECTION:
O SANITARY/LATERAL (PERMIT NO. CL _) ( ) FOOTING DRAIN
I
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: TIME: INSP: ��
CONTRACTOR: �y0-a,/ WEATHER: C-.ice= i
WORK IN PROGRESS: 1�5ro?oll-r
AREA OF CONCERN:
SPECIAL INSTRUCTIONS:
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