Loading...
HomeMy WebLinkAboutDrain Layers Permit 59 Charing Road TOWN OF SOUTH WINDSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT 6308 19 S Pursuant to written application, permission is hereby granted to the c�nsseedl Drain Layer name herein to perform the work indicated b low at • .47 C)-r�, at Premises own d y whose address is Aw .� c 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 proposed work or furnish two (2) copies of separate drawings . PIN— OSHA OSHA REQUIREMENTS MUST BE FOLLOWED SPECIAL CONDITIONS Desired Starting Date Estimate Time for Completionuc-4- /--Ij Perm'it to be ;issued to S : the holder of Drain Layer' s License No . Z-() J'Yr'l, 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 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 : LA 141 L E gi . ring Dept. Date Permit Fee Paid $ A5,©� Chec Number WAG:) Connection Charge Receipt No. W,%5- IDated kj Issued by, INSPECTION t Date work started ]- 33� Date completed 3/-�j' � Sufficient notificacion receive es No Special Conditions APPROVED: Inspector Date SANITARY LATERAL,& EXCAVATION PERMIT _ INSPECTION REQUEST DATE :OF .REQUEST- I �u�`,. ��.;��QS TIME: f0 �,S' 0- BY: \`n n Q�ll Tz�-%3A _ FOR LOCATION: DAY.. INSPEC'. .NEEDED �p�C,a,�C tlr `40M• RMTIME: .Nt tea+r1 TYPE OF 'ENSPECTION: i ( u) SANITARV LATERPn (PERMIT'.NO;. FOOTING. DRAIN.. t ( ) EXCAVATION (PERMIT NO. ) ( } OTHER b INSPECT. KW,REPC3R-T ,s ,........ .. i DA=.—, -ik 7—3/-N TIME: `'f l f�/ S / INS P: { CONTRACTOR �L-�2i3�� WEATHEIK. WORK -IN PROGRESS: ��.,, i y/�! /NII /�-1�/�-✓ lZ� S7�Y%1116�1� /A-Ao P � AREA OF CONCERN: SPECIAL INSTRUCTIONS: