HomeMy WebLinkAboutDrain Layers Permit 39 Charing Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 6245
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Pursuant to written application, permission is herby granted to the
icensed Drain Layer named erein to perform the work indicated bel w at
G at premises ed b (1J. C _
whose Address is..,' °J as Gli and to
Lay House Drain, Repair House Drain, Lay Main Other ,
forty, occupancy or use, with
Family Units , ith acres .
Type of Sewage to be connected under this permits SANITARY SEWAGE ("")
INDUSTRIAL WASTES ( ) , OR ( )
Connection, will be made with
Show sketch ,of proposed work or furnish two (2) copes 'of separate drawings .
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RE � EML�NTS�M3����B�F�,F�L�eOIE
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AL�CONITIONS
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Desiree g D t�e�; Estimated Tim7 for Completion
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Permit to"-'be' ssue Yto
the holder `of Drain Layer' s License No . Permit will expire thirty
( 30) days after date of issuance. The undersigrV&-d 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 .
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Signed r
Licer►ded Drain Layer
The above named Drain Layer has a valid license ,issued .by the State of
Connecticut and . has filed a satisfactory bond and insura-nce policy in the
name of the Town of South Windsor :
Engineering Dept . Date
Permit Fee Paid $ ZS-00 Check Number 1_0av4os�
Connection Charge Receipt No. Dated
Issued by
INSPECTION
Date work started 3/-9',�� Date completed ,.-
Sufficient notification receive : VYes No
Special Conditions
APPROVED:
Inspector .. . Date
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o _ �
Y SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: TIME:
BY: FOR LOCATION:
DAY INSPEC . NEEDED 'vim/ TIME:
TYPE OF INSPECTION:
( � ) SANITARY/LATERAL (PERMIT NO. Z��) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: TIME: Z INSP: /�WW
CONTRACTOR:- �L:J? G'�i �,vS t WEATHER: fL-L��41kl!'
WORK IN PROGRESS: ZZA��v�
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: