HomeMy WebLinkAboutDrain Layers Permit 185 Commerce Way t •i
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TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
DATE: e,
Pursuant to written application, permission is hereby granted to the-Licensed Drain Layer named herein to
perform work at 1, S Cu m n<,, -u wrry y , Lot# 2G as indicated below,at
premises'owned by Sn h tc,4,c boo /I hek- c whose address is /� ox , d QZ, s ,,,�,. d J, and
to Lay House Drain , Repair House Drain , Lay Main , Other , for
occupancy or use, with 't/ acres.
Type of Sewage to be connected under this permit. SANITARY SEWAGE(1, INDUSTR/AFL AST ES(*0
OR{) Connection will be made with (o V C. Al/
work to be in accordance with Town of South Windsor standards, al/OSHA requirements and the conditions
indicated-on.the back of this permit.
Proposed start date �' 2 C Estimated time for completion
F permit is to be issued to i3-e Mp" u<c i It the holder of DrainLayer's License No.
Z o 8 2 L o Only holders of P 1 P7& W9 licenses will be issued permit. Permit will expire M&& (30)
f days after date of issuance: The undersigned Drain Layer hereby agrees to al/the terms and conditions set
forth in a permit and the reverse side.thereof. Applicant has ce/ved To Street Excavation Permit No.
Z-Z- and/or ConnDOT Permit No.
. <�
Signed
L/c} used Drain Layer
. FOR TOWN USE Oft Y
Permit Fee Paid$ Z-1 (Check No.) S D >-T
Y N Connection Charge S 0 (Receipt No.) Dated krl
Insurance on File ( ( 7
Bond on File f ( I This permit is hereby issued to the abovv named Drain Layer who has a valid
license issued by the State of Connecticut and has on f yr e,sadsfactory bond
Premises subject to and insurance in the name of the Town of South Windsor.
Intertown Agreement ( I
Record of Sewer
Assessment O O Issued by Date
INSPECTION
Date Work Started 7/yl9t' Date Completed /f
Comments
APPROV D:
Inspector Da-e
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE-OF REQUEST: 5/9z-8c - TIME: , G,?�,�.�sew
BY: FOR LOCATION: �
DAY INSPEC. NEEDED TIME
TYPE OF INSPECTION:
( / ) SANITARY/LATERAL (PERMIT NO. 65/5�� ) . ( ) FOOTING DRAIN
( ) EXCAVATION . (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: TIME: INSP: T,L .�i�`•�/c�
CONTRACTOR WEATHER:
WORK IN PROGRESS: /2 '/o -- t2 ' 4/S� �'®�✓>���� Pv -�vr .� Gt��
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,g-.�6�o� .Pied 'r' .�ir/h ��c+✓e'� 1�99.�it/.�e9 L®: �- siz�� .�' ---
CoyGl�.d®T J1�T�.�4yQ� SgiY�.� �T / of .z- .✓�� /.d ,9/.e/��.r�`
/.�.QBd/J�G `.�oiH �'•��%s�3 s�i9l�/ �p.� �� �. 7''/�E"1� �iYi1/ �f�'��C``'G�
9�� 96 .Si�sft -•'/.�.,f/.ToG�r ter// �c� Qs .Co i!� "
AREA OF CONCERN: .
SPECIAL INSTRUCTIONS:
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