HomeMy WebLinkAboutDrain Layers Permit 10 Debbie Drive 6318
,,;TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
DATE:
Pursuant to written application,permis is hereby ranted o the Licen ed Drain Layer named herein to
perform work at 0 s Lot#Z_1r as indicated below. atl
premises owned by '' h se address is S- and
to Lay House.Drain , Rep Zr House Drain Lay Main , Other for 1/7
occupancy or use,`with acres.
Type of Sewage to be connected under this permit.•S N/TARY SEINAOE INDUSTRIAL;WASTES(J,
OR O rrnection M be made with S�"hi 3 S All
work to be in accordance with Town of South Windsor s ards, a#OSHA requirements and the conditions
indicated on the back of this°permit.
Proposed start date g - Ema�d tim completion `
- .—
Permit is to,be issued to 70 V - e holder of Drain 4ayer's License No
Only holders of P1, P7 & W9 licen will ed permit. . Permit will exoire thirtK(30)
days after date of issuance. The undersigned Drain er a grass Wall the terms and conditions set
forth in the permit and the,ieverse.side thereof. App nt he eV, T n Street Excavation Permit No.
and/or ConnDOT Permit No.
Signed `" 37
=in Layer
FOR TOWN USE Oft Y
Permit Fee Paid S •4a (Check No.) Ogs lz c -6 I S
Y N Connection Charge $1 USR.(Receipt No.) � Dated
Insurance on File
Bond on File (jQ ( J This permit is hereby issued to the above flamed 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
Record of Sewer
Assessment Issued b Date
fl ( J y
INSPECTION q q
Date Work Started 3D`-g S Date Completed
Comments
APPROVED
nspector Dam -,r
SANITARY LATERAL & EXCAVATION PERMIT
Y'
INSPECTION REQUEST
DATE OF REQUEST: 5o '-3 S TIME:_ F
BY: # FOR LOCATION: lig r
DAY INSPEC. NEEDED �� 3 d 5s TIME: �� f ,
TYPE OF INSPECTION:
( � SANITARY/LATERAL (PERMIT NO. ) ( } FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: Q - S TIME: M "Llij IN P:
CONTRACTOR: T44 WEATHER: °
WORK IN PROGRESS:
r
J '
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: /