HomeMy WebLinkAboutDrain Layers Permit 80 Benedict Drive A 6454
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMTT
DATE: 7 Z9a
Pursuant to written application,permission is hereby granted to the Licensed Drain Layer named herein to
perform work at 8o J a/V t a i C 'r -71Z S, w i"b '' , Lot# - as indicated below, at
premises owned by -Xa-r C o Fr-E y whose address is. 210 J g N/a rc r n Tz and
to Lay House Drain., Repair House Drain. , Lay Main , Other for
occupancy or use, with acres.
Type of Sewage to be connected under this permit.• SANITARY SEWAGE.� -INDUSTRIAL WASTES(1,
0100 Connection will be made with C "PVC- All
work to be in accordance with Town of South Windsor standards, all OSHA requirements and the conditsons
indicated on the back of this permit
Proposed start date 7 9 9 C Estimated time for completion 7 /1 9
Permit is to be-issued to rkkor- ,$`k / :�. the holder of Drain Layer's Ucense No.
d Oo?u r1`J Only holders of P Mrsign
& W9 licenses will be issued permit Permit will 're thirty (301`.
days after date of issuance. The uad Drain Layer hereby agrees to all the terms and conditions set
forth in the permit and the reverse side thereof. Applicant has received Stree Ezce o Permit No.
and/or ConnDOT Permit No.
C 13UD 4t- Signed
IF
Liakised Drain ayes
46-00136 S
4
FOR TOWN USE OM Y
Permit Fee Paid$2,5—00 (Check No.) P%f
Y N Connection Charge S�eO_ OO (Receipt No.) 6cys 3/ Dated ,
Insurance on File
Bond on File (✓', ( 1 This permit is hereby issued to the above named Drain Layer who has a valid
license issued by the State of Connecticut and has on Tile,satisfactory bond
Premises subject to / and insurance in the name of the Town of South Windsor.
Intertown Agreement ( 1 f✓I
Record of Sewer
Assessment ( I ( 1 Issued by .►-' Date
41
INSPECTION
Date Work Started Date Completed `
Comments
APPROVED
In�p , Gss-�i�'�cor�o Z. L
e or Date
SANITARY LATERAL & EXCAVATION PERMIT
r
INSPECTION REQUEST
DATE OF REQ$EST.: >���g� TIME:_
BY: /B�w �Z-=S,Ci•�S SAP>/C FOR LOCATION:----
DAY INSPEC. NEEDED 7/o TIME: n
/L 30
TYPE OF INSPECTION:
( SANITARY/LATERAL (PERMIT NO. y _) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: TIME: INSP:
CONTRACTOR WEATHER:
WORK IN PROGRESS:
L!?J� v'asi .s�'-,�,�Yc'"b - y✓i�G l'd! �-otosds ����s�'i✓.�y 7a
Tim- i..r/ro C�S�i.�o�/ �-� �.9'.r/oy> �� �I�cs'�®�- �•L�/�!
2 S�S� s�+►�-GC'T�� ST��✓6' '�T To f�cG �s/.�1r Cc/
si✓ �.�/dam-7.✓�f/
AREA OF CONCERN: .
.SPECIAL INSTRUCTIONS: