HomeMy WebLinkAboutDrain Layers Permit 352 Beelzebub Road ...F.. _ _...i.w..�.9•L'*tRt'�'11+1"iY'F.'•. - �` Y��,. a P*`.a� ,i l S4",�� .� ,:i,_.. _ � e.t,: . '-t
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT6274
19 ci S
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
at premises owned by Ann V cQQt 64t%%dorp
whose address is et-`zc bo, and to
Lay House Drain, Repair House Drain, : Lay Main, Other `,
for ('r-S t.,.ce occupancy or use, with T
Family Units , with acres .
Type of Sewage to be 'connected under this permit : SANITARY SEWAGE O6
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with SOQ 35 (o" Gs<sK4lr�, ...sa n� c
Show sketch of proposed work or furnish two (2) copies of separate drawings .
MovSE '
�.- --o6HA REQUIREMENTS MUST BE FOLLOWED
SPECIAL CO DITIONV e-�e
Desired .Starting Date S-5'S 5 Estimated Time for Complet--ion S'1-SS
Permit to be issued to (�,�� �r C �(�.��(+ C.c, Tr•c
the holder of Drain Layer ' s License No. aVV3acc 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 .
Signed ..•. A-41-4
Licensed Drain 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 :
L
Engineering Dept . . Date
Permit Fee Paid $ Z 5%v0 Check Number 7Z �
Connection Charge Receipt No. 92 7,- �(ao Dated 5- �
Issued by
INSPECTION
Date work started S = - ate completed �-
Sufficient notification received : 17 yes No
Spec-ial Conditions
APPROVE
�,�-:&,&Aj:�g�_
Inspector
i
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
_.` DATE-OF REQUEST: Jam- - 5 TIME: �, o
FOR LOCATION:
BY: ,
DAY INSPEC. NEEDED TIME:
TYPE!:OF INSPECTION:`
( } SA_ N`ITARY/LATERAL.'°(:FERMZT-`I NO.,.- " b 2 } ( }. FOOTING:. DRALN:. -
( ) EXCAVATION (PERMIT NO. ) ( } OTHER
INSPECTIO REPORT .,..
-DATE:,* S- TIME: 9 : 0 INSP•
.�
{ _ CONTRACTOR. - r C WEATHER: tj a4l-% .S✓S
WORK- IN PROGRESS: ,P/1
AREA OF CONCERN:
SPECIAL INSTRUCTIONS:
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