HomeMy WebLinkAboutDrain Layers Permit 44 Charing Road a.. i '', : .. ,• < a .. .. .,.. n .. .x_ ' _ 'fit `�.. .4-y�;.,,t. ..-��*
TOWN OF SOUTH w1 N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT NOW 6273
.3 199_S'
_Pursuant , to written application, permission is ereby granted to the
i ewed Drain Layer nam d herein to perform the work indicated b low) at
a pre ises ,owned by _ 614 co-,! �,��
whose address is and to
Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use, with ,(' • ,�L_
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 rawings .
ell- f 11q-1-
i �
d
OSHA REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONS
Desired Starting Date '". S• Estimated Tim for Completion` F-`
Permit to be issued to .
the holder of Drain Layer's L cense No . 7-vktls Permit will expire thirty
( 30) days after date of issuance. The unde-rsigned 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:
Engineering Dep1t . Date
Permit Fee Paid $ z S'.a Oo Check Number e,9B 0 4"7— d
Connection Charge Receipt No. 5 JD a t e d
Issued by
INSPECTION - - -
Date work started t ate completed
Sufficient notificad
Ion rece ve es No
Special Conditions
APPROVE 47
Inspect r Date
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE. OF REQUEST: S"". �- 9 .�L, TIME: 2
BY:
_ FOR LOCATION:
DAY INSPEC. . NEEDED TIME: �-44
s TYPE. OF INSPECTION; - -
SAKI TPiRg/TIATERAI�, (PERMIT 'N0>.�
FOOTING,.,.DRAIN.
( ►} EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECT70WREP4IRT;
DATE: '3/-' 9 S TIME: 9'.06 Z:Oy INSP:
3<; CONTRFCTO :'' /e '1 WEPr7.'F€EA. �:�a✓� D °�-
m
WORK'_I PROGRESS
A- n _fv Aa,(a atv_dAia
r
3,
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: