HomeMy WebLinkAboutDrain Layers Permit 16 Diggins Court TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT ! 6 014
—7 , I9
Pursuant to written application, permission is hereby granted to the
Livens d Drain Layelr ,named herein to perform the work indicated` below at
�p 84aaJ..A1,WCT J �� t premises. owne by Con s7�
whose address `� o� .5ayGv>' �� a tQ.
Lay House Dr n, Repair H se Drain, L
aay Main, Other
for , occupancy or use, with T
Family ,Units with acres. [
Type of Sewage to be connected under this permit: SANITARY SEWAGE± ( ,
INDUSTRIAL WASTES (,_ ) , OR
Connection. will be made. with, $7. l,y' p ,�
Show sketch of proposed work or furnish two 2 copies( ) p separate drawings.
O HA REQ'UIREME14TS MUZ&EF•OIjLOWED
SPECIAL CONDITIONS �S /
Desired "Starting Date Estimated Time for Completion
Permit to be issued to p UPS'
the holder of Drain Layer's, License No. 2.0 S Permit will expire thirty
(30) , days after date of issuance. T`ie' undersigned Drain Layer hereby agrees
to all the terms and con4ttions set . forth in the permit and the reverse side
thereof. Applicant has received Town Permit No. and/or
CHD Permit No.
Signed G
I:ice ed Dr in Layer
The above named Drain Layer has a valid license issued by the State of
Connecticut and has filed a. satisfactory b nd and insurance policy in the
name of the Town of South Windsor: f
gin ing Dept. Date
Permit Fee Paid U ) Che k umber
Connection Charge Receipt No, la's, Dated Cat
Issued by ,� �-
f l
INSPECTION -- ---
Date work started 9 - 2 — Date completed
Sufficient notification rece ve : ,7—Yes No
Special Conditions
APPROVED:," f�-g-q3
Inspector Date
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
r
DATE OF REQUEST: TIME:
BY: FOR LOCATION:
DAY INSPEC. NEEDED TIME:
TYPE OF INSPECTION:
( ) SANITARY/LATERAL (PERMIT NO. ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) { ) OTHER
INSPECTION REPORT
11
DATE: T 3 TIME: /O;TO - �.30 L��AG INSP:
CONTRACTOR: J WEATHER.
WORK IN PROG SS:
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: