HomeMy WebLinkAboutDrain Layers Permit 9 Diggins Court �. . TOWN OF SOUTH WINDSOR w
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT No62
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Pursuant to written application, permission. is hereby granted to the
Licensed rain Layer named he n to perform the work indicated below at
U at premises .owned by , 7/yJ " / �-
whose addres G $ s , a,
Lay HouseDra � , Repair H d:6se D ain, Lay Main, - Other ,
-
for occupancy or use, with Timed 7v
Family Units , ith acmes .
Type of Sewage to be connected under this permit : SANITARY SEWAGE ( !
INDUSTRIAL WASTES " ( ) ;OR
Connection will be made with 7{ '24=
Show sketch of propoeed work or. furnish two (2) copies of separate drawings.
OSHA REQUIREM NTS. MUST BE FO OWED
SPECIAL CONDITIONS
Desired. .Starting Date — O S" Estimated Time for Completion ./
Permit to be issued to
the holder of Drain Layer ' s License No . ?.62ZL.9Q Permit will expire thirty
(30) days after date of issuance. The undersigned 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
Lice d :ed
n Layer
The above named Drain Layer has a val license iss by the State of
Connecticut and has filed a- satisfactory bond and insurance policy in the
name of the Town of South Windsor:
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E gin e. ng Dept . Date
Permit -Fe.e Paid $ � �Q Check Number U �
Connection Charge Receipt No. rz Dated.
Issued by
INSPECTION
Date work started - Date completed '� "Z ¢
Sufficient notifica on rece vea es No T~
Special Conditions
APPROV c ft
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Inspector Date
SANITARY LATERAL.&".EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST.: 4-— 2 ¢- 5 TIME
BY:. FOR LOCATION:
DAY INSPEC. NEEDED_. • 2-4:—2S TIME:
' TYPE OF INSPECTION:
' ( ) SAN:ITARY/LATERAL, :.(•PE tMIIT NO, FOOTING. DlUI.N:
( } EXCAVATIL)N (PERMIT NO. )' ( ) OTHER
INSPECTIOW REPORT:.
DATE: `Z. / TIME: � INSP:
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CONTRACTOR: WEA:THER'r i. S
WORK IN PROGRESS: L. F.
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AREA OF CONCERN:
SPECIAL INSTRUCTIONS: