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HomeMy WebLinkAboutDrain Layers Permit 64 Charing Road TOWN OF SOUTH WI N DSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL k DRAIN LAYER'S PERMIT 6218 19 Pursuant to written application, permission is hereby granted to the Lic n ed Drain. La meg herein to perform the work indirlated b lowfat at premises owned by Yf2 ,, y( whose addrdss, is 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 willbe made with � + C Show sketch of proposed work or furnish two (2) T es of separate drawings . ( V Uel o�-G a)1 -I OSHA REQUIREMENTS MUST BE FOLLOWED SPECIAL CONDITIONS Desired Starting Date oV,07 Estimated Ti a for Completion Z—Z, �t Permit to be issued to the holder of Drain Layer' s License No. Z _r Permit will expire thirty ( 30) days after date of_ issuance. The undersigned Drain Layer herebyagrees 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 . le Signed wt- 4 'Licensd 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 : 0011 Engineering Dept . Date Permit Fee Paid $_ .©Q Check Number Connection Charge Receipt No. Dated Issued by , INSPECTION Date work started / 2 - 7- 24= Date completed LL- 7— 4 - Sufficient notification received : yes No Special Conditions Inspector Date SANITARY LATERAL & EXCAVATION PERMIT INSPECTION REQUEST DATE OF REQUEST: 91— TIME: BY: �� �(y , FOR LOCATION: DAY INSPEC. NEEDED 2 6—9`Y— TIME: . TYPE OF INSPECTION: ( ) SANITARY/LATERAL (PERMIT NO. FOOTING DRAIN ( ) EXCAVATION (PERMIT NO. } ( } OTHER INSPECTION REPORT DATE: / 2, —-7—9 4— TIME: INSP: CONTRACTOR: 0200 &all WEATHER: WORK IN PROGRESS: a.,l Q-v► -� f AREA OF CONCERN: SPECIAL INSTRUCTIONS: