Loading...
HomeMy WebLinkAboutDrain Layers Permit 036 Austin Circle TOWN OF SOUTH WINDSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL I DRAIN LAYER'S PERMIT ! 6270 Pursuant to written application, permission is hereby granted to the Liven Drain Lamed h�71,0�1;;�remiaes into per the work indicated below t wh--�o owned b se address s so SQ a , to -Lay House Drain, Repair H90se Drain, Lay Main, Other for M1 1 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 ,5 _byl- 34;` Sr°?a�u' Show sketch of proposed work or furnish two (2) copies of separate drawings . OSHA REQUIREMENTS MUST E SPECIAL CONDITIONS GS .q ,/FLLOW! Desired Starting Date -- — Estimated Time for Comple t i o.n_4,2e, Permit to be issued to Ilk, the holder of Drain Layer' s License No . >p5$30 . 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 . . and/or CHD Permit No . ti Signed Ar-X� TeensVdDra;Zy Layer The above named Drain Layer has a valiicense the State of Connecticut and . has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor: Al)/�) /y -Z-7 -9 Engineering Dept . Date Permit Fee Paid $__ .Q� Check Number G/1JJ Connection Charge Receipt No. Dated �7V r� IV(S- Issued` by INSPECTION Date work started 12. -9 Date completed Sufficient notification receive3T Yes No Special Conditions APPROVE Inspector Date SANITARY. LATERAL & EXCAVATION PERMIT n INSPECTION REQUEST ..DATE OF RF0_UES'T y 42 J=�� TIME: /O FOR LOCATION: DAY INSPEC. "NEEDED TIME: - TYPE OF -INSPECTION } SANITARY/LATERAIL PMU417 WG-=,CoZ70 F©QTINCr I3RI II1.,_. EXCAVATION '= (PERMIT" NO ) ( } OTHER. IN-SPECTIOU,-HEPOWT, ,.., DATE: '..�- /Z� 2r TIME: 1:00 //"INSP: CONTRACTGX-.: - Zy� WEATI ER: s S e WORK IN PROGRESS: Ll ' n AREA OF CONCERN: SPECIAL INSTRUCTIONS: