HomeMy WebLinkAboutDrain Layers Permit 450 Abbe Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 6232
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Pursuant to written application, permis-sion is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
— Sa f�flQE ?1D W/ at premises owned by J'4772/cf W/4L SOA/
whose address is 4Sd q 8c- TZb S. 1,j1/Wb and to
Lay House Drain, __Repair House Drain, Lay Main, Other ,
for S/NGcc- 04,h/Ly occupancy or use, with
Family Units , with acres .
Type of Sewage to be connected under .this permit : SANITARY SEWAGE O ,
INDUSTRIAL .WASTES ( ) , OR ( )
Connection will be made with
Show skeycB -avor v0sed work or furnish two (2) copies of sepa°r�gte drawings .
3
s OSHA REQUIREMENTS MUST BE _FQ, ,LOWED
SPECIAL.''-:C0'9brTIONS
'� . "
Desired Starting Date /.7- 29 17 Estimated Time for Completion /z i9
Permit to be issued to dv,qL1 ER. cSk/PS 5�17C 45�aY/eAF
the holder of Drain Layer ' s License No . 40774.5" . Permit will expire thirty
( 30) days after date of issuance. The und-ersigned 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 . nd/or
CHD Permit No.
Signed
VefisedF_Dra-in 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 Dept . ' Date
Permit Fee Paid $ ZS'� Check Number, , ?
Connection Charge Receipt No. e Z-3Z,,� Dated
Issued: by
INSPECTION
Date. -work started Z- 3r,�-9' Date completed 30-?,51
Sufficient notification receives: es No
Special Conditions - /51//Z 7 '/
APPROVED:
Inspector . Date
A SCANNED
A
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: /2 I2g TIME: 9-'U U
BY: FOR LOCATION:
DAY INSPEC. NEEDED 422 TIME:
TYPE OF INSPECTION:
( x ) SANITARY/LATERAL (PERMIT NO aC--a 5a ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: l Z� 3U'�/� TIME: - INSP:_�/�9✓�/�
CONTRACTOR: WEATHER:
WORK IN PROGRESS:
AREA OF CONCERN:
SPECIAL INSTRUCTIONS:
bLANNIED
1