HomeMy WebLinkAboutDrain Layers Permit 74 Charing Road ;r', •`} -1'.`FTT*.•T ' ii#a i'#'� 4l '�+ K ,3.• . - ;a ddt:•K'
6384
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
. ..DRAIN LAYER'S PERMIT
DATE:.
Pursuant to written application, pervission�ereby granted to the Licensed Drain Layer named herein to
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perform work at_ of#_ s indic�j�ad b low, at
premises owned by whose address is Clof C Alt C� and
to Lay House Drain Repair House Drain , Lay Main Other , for
r occupancy or use, with acres.
Type of Sewage to be connected under this permit; SANITARY SEWAGE. /NDUSTR/AL W STES(1
OR() Connection will be made with Zw AV C— . All {
work to be in accordance with Town of South Windsor standards, a//OSHA requirements and the conditions
indicated on the back of this permit
Proposed start date Z _Z f Estimated time for completion /Z
Permit is to be issued to &t. e-. 61.). the holder of Drain Layer's License No.
Zo R yS-L---. Only holders of P1, P7& W9 licenses will be issued permit Permit wi//expire thirty(30)
days after date of issuance. The undersigned Drain Layer hereby agrees to a//the terms and conditions set
forth in the permit and the reverse side thereof. Applicant has received own S eet Excavation Permit No.
and/or ConnDOT Permit No. ;;QQ
Signed
Ucensed 6425 Layer
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FOR TOWN USE Oft Y
Permit Fee Paid$ .S"' ! (Check Noa `'�'
Y N Connection Charge $ 66kv ,.•;-" Receipt No.) e, 9' Dated /z,-z7-
Insurance on File (�t1{ 1
Bond on File (N ( 1 This permit is hereby issued to the above named Drain Layer who has a valid
license issued by the State of Connecticut and has on file,satisfactory bond
Premises subject to and insurance in the name of the.Town of South Windsor.
Intertown Agreement ( 101
Record of Sewer
Assessment ( 1 ()9 Issued by /- /� Date
INSPECTION
Date Work Started 2-7-9'y Date Completed
Comments
APPROVED;
Inspector Date
SANITARY LATERAL.& EXCAVATION PERMIT
INSPECTION REQUEST"
DATE,'OP'.NE�,IIEST .Z.i 27- TTME
BY.: FOR_ LOCATION:
DAY INSPEC NEEDED:: "/Z- Z7-- ,;'� TIME: �
-TYPE- OF •INSPECT'Laft '._ <
,FO0TING_�'1 1� l
( ) EXCAVATION (PEEiMIT.'NO. ) OTC
INSPEC-n-GWREPO
DATE.: .._ _7,7_ 95� TIME
CONTRA=ON: �� / �- ��✓S�� WEATH£I : �� ✓�
WORK IN -PROGRESS.:.
4,10
AREA OF CONCERN:
SPECIAL INSTRUCTIONS:
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