HomeMy WebLinkAboutDrain Layers Permit 197 Brook Street (2) . ` .w m,wv.' .r,F+vS-r.rgg••q-•-r•syfl. }y..,,...pt•ss'c^xh+yFi•,?`t' 3 :# `i'*.` "*. r.�..y7fi "i.ra=dw.�r+.T, N• 21A.iY�rp� .`i'"!" ?: YaG•p&nt �c.. „ ,.
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TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT !
- 19
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 yes^Ab/
whose address is 4q and to
Lay Hop)s�e DrainRepair House Drain, Lay Main, Other ,
for I�,c.S� �riN occupancy or use, with f
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 ( } copies of separate drawings,
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OSHA REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONS
Desired Starting. Date Estit,0144=
ed Time for Completion
Permit to be issued -to Ok —
the _holder -of Drain Layer' s License No. 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 JA
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,: -
Engineering Dept. Date
Permit Fee Paid $ ✓' Check Number
Connection Charge Receipt No. 10,3 e), Dated may r"
Issued by
e
AINSPECTION
Date work started -7-7 Date completed
Sufficient notification rece3vea: "-Yes No r`h`
Special Conditions
APPROVED:
Inspector Date
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SANITARY LATERAL & EXUAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: (� f" ( TIME:
BY: /,rZlG*'� /�f �I�/ FOR LOCATION:
DAY INSPEC. NEEDED AlelLl `lG{ TIME 0
TYPE OF INSPECTION:
-� FOOTING DRAIN
SANITARY/LATERAL (PERMIT NO. �j"s/,j 7 ) ( )
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: TIME: 7 INSP:
CONTRACTOR: 1jG // z WEATHER:
WORK IN PROGRESS:
AREA OF CONCERN:
SPECIAL INSTRUCTIONS:
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To heTp,.locate ;�rau,^Ksewersconnectiori<on�ttie main l,rtes"please shoinr.. . 4
where you would like the connection by drawing a line From the hocase or, 4
the septic tank to the PMair ,Line`to the. street :Also install•stake in }
to indica—jtne as•sho ' d }
w on sketch TFyou have any doubt please contact � s f ; :.�
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