HomeMy WebLinkAboutDrain Layers Permit 100 Bramblebrae TOWN OF SOUTH WINDSOR
i DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
I
DRAIN LAYER'S PER14IT N2 6038
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,/ i , 1992
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer reamed herein to perform the work indicated below at
at premises owned by
whose address is \ (Dv
Lay House Drain, Repair House Drain, Lay Main, Other and to
for occupancy or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (�f,
INDUSTRIAL WASTES ( ) , OR ( ) -
Connection will be made with Gig 0C
4 Show ietchrof ro osed work or furnish 'two (2) copies of separate drawings.
REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONS
Desired StartingDate �c„�t-_
\\ Estimated Time for CQg�gle�ion
Permit to be issued to ` •�lc"
�r n �. yjy0 ,:::JL0 es.
the holder of Drain Layer's License No. Permit will 'expire thirty
(30) days after date of issuance. The un ersigned 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"
.T� icenaed 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:
fl-U En ineering Dept. t' Date
Permit Fee Paid $ Check mber
Connection Charge Receipt No. 43g34- Dated
Issued by
INSPECTION
Date work started --o No
completed 4 -09-93
Sufficient notification r c ve
Special Conditions
APPROVED-
Inspector Date
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SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
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#; DATE OF REQUEST: 0&0 TIME: 4'd d
BY: �E ir�t G� FOR LOCATION: 16 0 �L ^�l�L�
j' DAY INSPEC. NEEDED TIME:
TYPE OF INSPECTION:
SANITARY/LATERAL PERMIT NO. C� 8
( �) ( ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
g:
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5'
INSPECTION REPORT
F' DATE: �- TIME: �(� d INSP:
CONTRACTOR: WEATHER:
WORK IN PROGRESS. lf
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AREA OF CONCERN:
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SPECIAL INSTRUCTIONS: