HomeMy WebLinkAboutDrain Layers Permit 0463 Avery Street r TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 6056
19
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
,-4a5 jdat-2y yST at premises owned by R0131NVrIL=
whose address is ¢6,3 pp�;-,t y sr- a#U- 1 G,i,U 01- c r and to
Lay House Drain, (_Repair House Drain, Lay Main, Other
for �-TIAIGGg- 6A.- M/l / 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
OS REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDIT ONS
Desired Starting Date 1 &9--� Estimated Time for Completion / y3
Permit to be issued to �'r1ti, L�Ack� rSkY�S S.5€P77G U/ -
the holder of Drain Layer's License No. 3o77aS 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. Azl and/
CHD Permit No. - x
t /�
Signed
. L censed Drain La ye
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 $ Z� Check Number ?
Connection Charge Receipt No. —Dated—
Issued by �D
INSPECTION'
Date work started /Z -�- j Date completed Z - -g
Sufficient notificaE on ecel e : ✓"yes No
Special Conditions
Inspector Date
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: J - 7- 93 TIME:
BY: u d", FOR LOCATION: 443Q�
DAY INSPEC. NEEDED 12 - 9 3 TIME: 1 A 1 010
TYPE OF INSPECTION:
( �) SANITARY/LATERAL (PERMIT- NO.- � Q,5'(0 ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: 2 - TIME: Q ' 3 d INSP:
CONTRACTOR: EATHER: (2 " oi
WORK IN PROGRESS:
lez�� ;4-
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: