HomeMy WebLinkAboutDrain Layers Permit 70 Carson Way Ak
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 6305
Ise
19
Pursuant to written application, permission is hereby granted 'to the
L ' ced�Dra Layer named hgre n to perform the work indicated below at
SGW! at Premises ow ed by 7'f')/�TC10
whose address is and o
Lay House 'Drai , Repair H use Drain, Lay Main, Other ,
for i occupancy or use, with j j
Family Units , dith acres . � .
. 'Type of Sewage ter 'be cc�t�neC.•ted under this permit : SANTTARY E• `
_� SEWAG
( 1 .
INDUSTRIAL ,WASTES ( , , OR
Connection will be made with
Show sketch -of proposed work or furnish two (2) copies o separate drawings .
OSHA REQUIREMgNT M ST F LONE
SPECIAL CONDIT'ION:S G,
Desired Starting Date Estimated Time for Completion
Permit to be issued to rN
the holder of Drain Layer ' s Licens No . Perm Y . ,7.4=,& it will expire thirty
( 30) days after date of issuaince. .The ,:-enders-ign,ed,,Dr,ai.n Layer hereby agrees
to all the terms and conditla s" set f,prth in the permit and the reverse side
thereof . Applicant has--'re"ci eive-d TaV'n" Permit No. and/or ' '
R
CHD Permit No .
Signed .
Z)-4 411,"
Li ense rain yer
The above named Drain Layer has a vali license i sued ey 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 $_-35.00 Check Number 6G
Connection Charge Receipt No . Dated '25-gJ
Issued by /i.
INSPECTION
Date work started /bate completed � z
Sufficient notification re eivea ; A.- yes No
Special Conditions
APPROVE '7 Z
Inspector Date
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST- 7` 21 e— 9 5 TIME:
BY: FOR LOCATION:
• DAY INSPEC. NEEDED --` g '�}� TIME:
TYPEOF INSPECTION:
SA_ NITAR`Y^CLZ TER-;I -, -PERMIT.:NO; fj FOOTING.,DRAIN.,.
( ) EXCAVATION A PERMIT -NO. ) ( ) OTHER
INSPECTION;,RERO#-T.
F
DATE. rg-2 TIME: e D c INSP: ��,,��
WEATIM—R ' L&
'0 ®f'
WORK Ili, PROGRESS ,
AREA OF CONCERN:
:' SPECIAL INSTRUCTIONS: