HomeMy WebLinkAboutDrain Layers Permit 84 Charing Lane TOWN OF SOUTH W1 N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
01006_ 1� DRAIN LAYER'S PERMIT 6363
Lek -
_AeJ 21 19 7-5'
Pursuant to written application, permission is hereby granted to the
Licensed Drain �ayer named herein, to perform the work ind Gated below aV
- at premises owned b ,� ' C�,ru� �yV,
whose address is 9 4A and to
Lay House Drain, _ T e p a i r House Drain, Lay Main, Other ,
for ` ocodpancy or use, with
Family Units, with acres .
Type of Sewage to be connected under this permit : SANITARY P A SEWAGE ( ) ,
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with G
Show sketch of proposed work o furnish tw& (2) copies f separate drawings .
OSHA REQUIREMENTS MU T E OWED
SPECIAL CONDITIONS
Desired Starting Date ` - Estima Tim for Completion CA 9
Permit to be isske'd to �..-
the holder of Drain Layer' s License No .tV -2,.....- 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 . dj .r
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 .sati4factory bond and insurance policy in the
name of the Town of South Windsor:
Engineering Dept . Date
Permit Fee Paid Check Number Z610
Connection Charge Receipt No. 43 Dated 2gjgj,, �,
Issued 'by
INSPECTION
Date work started --Z(-°J Date completed A 'ag" g--Z `-9j
Sufficient notificari n rece vvea-: 7 Tes No
Spec#al Conditions
a
r APPROVED. 2I
n pector Date
w .
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: Quit 2/ /9 P-5� TIME:
BY: � � -R.nL6 FOR LOCATION:
DAY INSPEC. NEEDED agm, Z i-I Zg. /ems TIME: 2 `. 00 0�1 T N„ 4-Zf95
TYPE OF INSPECTION:
( � ) SANITARY/LATERAL (PERMIT NO. FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( } OTHER
INSPECTION REPORT
DATE: ¢.- TIME: 2 :00 P,,r,,; INSP:
CONTRACTOR: /2,/yt aal en WEATHER: /1 O o
WORK IN PROGRESS:
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: