HomeMy WebLinkAboutDrain Layers Permit 120 Austin Circle TOWN OF. SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
zo DRAIN LAYER'S PERMITN 2, 6028
19
Pursuant to written application, permission is hereby granted to the
WensedD din Lay r named er n to perform the work indicated below at
r All g
at r wises owned y S -�'" (,� �-{,
hose address is / a tq
Lay House Drain, Repair Aouse Drain, Lay Main, qt er
for occupancy or use, with �i-
Family Units, v4A acres.
Type of Sewage to be connected under this permit: S
INDUSTRIAL WASTES ( ) , OR (. ) p SANITARY SEWAGE
Connection will be made with e
Show sketch of proposed work or furnish 'two (2) copies of separate drawings.
SPECIAL CONDITIONS OSHA REQUIREMENTS MUST BE FOLLOWED
Desired Starting Date //9 ,�47:�Es.timated Time for. Completion _
Permit to be issued to
the holder of Drain Layer's License No. �Ggg3�j Permi 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 t has received Town Permit No. and/or
CHD Permit No.
Signed
Linens' d DralA Layer
The above named Drain Layer has a valid li4 a 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 $- �`%�"� Check Number 42 � "3 0 7>
Connection Charge Receipt No. L/ 37 Dated `(J -13 - l3
Issued by
INSPECTION
Date work started /0- �^ /�� Date completed '93
Sufficient notiffca ion rece ve , es No
Special Conditions
le Of
APPROV c ����
Inspector Date
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: 16 - 1 9�g TIME:
BY: FOR LOCATION: /0 3
DAY INSPEC. NEEDED TIME:
TYPE OF INSPECTION:
( � ) SANITARY/LATERAL (PERMIT NO. Z Q ) (� ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: /Q Z f- 4 j TIME: /a ; o a INSP: ►�-��
CONTRACTOR: WEATHER: tfllu� 5^
WORK IN PROGRESS:
s.. T-9 3
AREA OF COrAg-.Z4V@
SPECIAL INSTRUCTIONS: