Loading...
HomeMy WebLinkAboutDrain Layers Permit 23 Cala Lilly Lane w TOWN OF SOUTH WINDSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT «` 0 r 47 Pursuant to written application, permission permission is hereby granted to the Licensed Drain La er named herein to perform the work indicated below at at premises owned by y4rz2a 'r whose address is D6f/i✓ �,d/� 41/a��i� and to Lay House Drain, _Repair House Drain, Lay Main, Other , for 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 roposed work or furnish two (2) `copies 'of separate drawings. SPECIAL CONDITIONS Desired Starting Date p Est.imated. Time for Completion -5' �ev 5 Permit to be issued to /✓- < l/1�/,�f/`yv� J c�SowuS. 1IVG the holder of Drain Layer's License No. ,_, 0,f.2r Jr . Permit will expire thirty (30) days after date of issuance. The undersigned Drain _Laye.r hereby agrees to all the terms and conditions set forth. in the permit and the reverse side thereof. Applicant has received Town Permit No, andtor CHD Permit No. S i e dL_ --�.� 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 iin_. the name of the Town of South Windsor gtgt `t2 E %ne ring Dept. Date Permit Fee Paid $ 2 S Check ber Connection Charge Receipt No. A Dated` Issued by W6.2,�, -4k 741 QY INSPECTION Date work started Date completed- � --, Sufficient notification rece ve : es No ' Special Conditions AP P Inspector Date TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: '���'�� BUILDING ADDRESS OR LOT N° : STREET: C IkLLA L-I L LA, SUBDIVISION: PqA-cHaaot)K,l: 0 "-/ uT oF12 DI+ T J ;;�fo 41 NH STATION : + ©s (YYIH 12) NORTH ARROW INVERT ELEV: , q ILI0,� TIE TIE -FT -FT. HOUSE _____ LATERAL LATERAL HOUSE CONNECTION STUB STUB CONNECTION IsT,rz FT. 2 FT. BUILDING INV. ELEV. INV.ELEV. INVU. . ELEV. INV. ELEV. BUILDING (IF EXIST.) t (IF EXIST.) TIE TIE 1(0 Mirik : ♦ �►"'I / INVERTELEV: , S(?•i6 W X W I LLI A M,7 t S o rl � fo12el(:., Ppo dek- CONTRACTOR (PRINT) NAME TRACTOR' SUPERVISOR(PRINT) CON � - STREET ADDRESS S I G N-ATVR4 DATE TOWN STATE ZIP INSPECTED BY TOWN DATE ( 7t 79 (e --Li37b TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW -CONSULTING ENGINEER/DEVELOPER