HomeMy WebLinkAboutDrain Layers Permit 045 Austin Circle a
N 640
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
LAYER'S PERMIT
DATE: _
Pursuant to writ# a pl/cation, permission is hereby granted to the Licensed Drain Layer named herein to
perform work at Sf,r� `P l� L t# 7 as indicate be, a
premises owned by o -whose address is S / and
to Lay House Drain Repair House Drain' , Lay Main ,'Other f '
occupancy or use, with / acres.
Type of sewage to be connected under this permit. SANITARY SEWAGE. Mr INDUSTR/AL WASTES<1
OR f) Conneodon,w//l be made with, TA A 5 A#
work to be in accordance with 'Town of South Windsor standards, all 05HA requirements and the conditions
E.
indicated on the back of this permit.
Proposed start date "" 2'"46 Estmat d't/me for completion ,
Permit is to be issued to': 3e holder of Drain Layer's Ucense No.
2 OS S 3 0 Only holders of P 1, P7 & W.9 i1ceilses Will Lte14sued permit. Permit will expire thirty 00)
days after chits of issuance. The undersigned Dr n Layer hereby,agrees to all the terms and conditions set
forth in the permit and the reverse'side thereof. Applicant has received Town Street Excavadon Permit No.
and/or:ConnDOT Permit No.
Signed ~ '
.Uqe' rDr Layer .
FQR TOWN USE OK Y
?s"tsd
iPermit A ' Paid$ � .:;.(., ,heck No.) 90 6 e3
Y N C'onne t o Charge S do�w a 7�Raceipt No.) Sr 6 0 'l Dated
Insurance on File + G
Bond on File f Vl`( 1 This permit is hereby/sued the above named Drain Layer who has a valid
karise issued by the State Corr ►"cut and has on Ne,satisfactory bond
Premises subject to and insurance in the name the Town of South Windsor.
"Intertown Agreement
Record of Sewer M..
Assessment - l ) !of lssued byA LL J Date
t
INSPECTION
Date work Started Date Completed 2 9
Comments
APPROVED:
Inspecto Date
.i
i
77
`- OWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LA 'YER S PERMIT
DATE:
Pursuant to written application, permi sion is hereby granted to the Licensed Dr * Layer named herein to
perform work at S s -[� Lot# as indica ed below, at
premises owned by whose address is t3all and
to Lay House Drain , Repair House Drain Lay Main Oth for
occupancy or use, with.�'r� acres.
Type of Sewage to be connected tinder this permit., SANITARY AGE I1�1, INDUSTRIAL WASTES(J,
OR(I Connec on wi!/be made withR 35 All
work to be in accordance with Town of South Windsor standar s, all OSHA reggirements and the conditions
indicated on the back of this permit.
Proposed start date 3--0 V4?6? Estimated ti a for completion, IDAV
Permit is to be issued to the holder of Drain Layer's License No.
2689.3e Only holders of Pf, P7 & W9 li ns s will be issued permit. fevmit will exnive thirty <301
days after date of issuance. The undersigned D ai Layer hereby agrees to all the terms and conditions set
forth in the permit and the reverse side,thereof. pplicant ha received T wn Street Excavation Permit No.
and/or ConnDOT Permit No.
Signed .C�
Lice Or Layer
FOR TOWN USE ONL Y
Per it Fee Paid$ (Check No.) Q!)DO& FC
Y N C nnection Charge $ O'? (Receipt N5.1 .tiO0.O0 Dated �Z �
Insurance on File (W( J
Bond on File (N'( J This permit is hereby issued to the above named gain Layer who has s valid
license issued by the State of Connecticut and has on No, satisfactory bond
Premises subject to and insurance in the nine of the Town of South Windsor.
Intertown Agreement
Record.of Sewer
Assessment ( J 1 Issued by 1/'> Date
INSPECTION
Date Work Started Date Completed a
Comments
APPROVED:
Inspec Dam
f' SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: 3—2-4 - g G TIME:
BY: /�ejy
FOR LOCATION:
DAY INSPEC. NEEDED �i� —'� �o TIME: 19
TYPE OF INSPECTION: Gyo�
( � ) SANITARY/LATERAL (PERMIT NO. w'� ) ( ) FOOTING DRAIN
(Uoidca)
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: TIME: INSP• G��/fie✓
CONTRACTOR: T�_T WEATHER:WORK IN PROGRESS:
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: