HomeMy WebLinkAboutDrain Layers Permit 67 Carson Way . ,.... . -.... w ..,, ..,p,.f,- ..,R_•y7. '.:rr•T.,,-cC�::Js*' %'...,.r! n r.-Gf+ •-:;^wS'"f_ _
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS '
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 1 6136.
Pursuant to written application, permission i-s hereby granted `-tb - tbe
Licensed Drai S ,a ed he ein a form the work indicated. below a
l e ses�� 9one by
whose address is f „� / y7e2 All ajxr to.
E Lay Howe Dr' in, Repai House Drain, Lay Main, Qthe ,
for �K1 2 / occupancy or use, with i E'
Family Units, with acres.
Type of Sewage to be connected under this permit : SANITARY SEWAGE ( ,
INDUSTRIAL WASTES ( ) , OR
Cohnection will be made with 4
Show sketch of proposed - work or furnish 'two (2) copies of separate draw4gs.
O A' REQUIREMENTS MUST LLOWE
SPECIAL CONDITIONS 3" e e
Desired Starting Date - Estimated Time for Completion
Permit to be issued to L '
the holder of Drain Layer' s License No. 'jj0C"$ _.X,6• Permit will expire thirty'
(30) days after date. of issuance. The unde:rsigned' Drain Layer hereby agrees
to all the terms and conditions set forth in the permit and the. revers.e side
thereof . Applicant has received `Town Permit No. and/or ,
CAD Permit No.
Signed ..
1,7L1ke_nsqdVDra Layer
The above named Drain Layer has a vali 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: 114- •:� £
Engi eri ept. : Date
Permit Fee Paid $ 2-S -oC� Check Number
Connection Charge Receipt No. 44LL ated
Issued by 1
INSPECTION
Date work 'started G — Zo c� Date completed
Sufficient notification rece ve : Yes No
Special Conditions
APPROVED:
Inspector Date
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: TIME:
BY: FOR LOCATION:
DAY INSPEC. NEEDED C-, ` TIME:
TYPE OF INSPECTION:
O SANITARY/LATERAL (PERMIT NO. �/3G ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: - � Gf TIME: /�C9z7 INSP:
''
CONTRACTOR: [/ ✓ WEATHER:
WORK IN PROGRESS: �Lrz�l Lj'L l iz� � DL IZ7;
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: