HomeMy WebLinkAboutDrain Layers Permit 14 Diggins Court ,. TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
3 DRAIN LAYER'S PERMIT 6269�j
/ 19
Pursuant to written application, permission is hereby granted. to the
Licens Drain ayes named herei to perform the work indicated below t
��0 a /Qf at pr09 emi es own d by
whose address s ari o
Lay House Drain, Repair HoUse Drain, Lay Main, Other , .
for occupancy or use, with
Family Vnits, with acres .
Type of Sewage to be connected under this .permit: SANITARY SEWAGE
INDUSTRIAL . WASTES
Connectioiv will be made with5D R 3
r
Show ske.t:ch of proposed° work or. furnis ltwo (2) copies of separate drawlri-gs.,
0 HAG2 QUIR S MUST BE OLLOW
SPECIAL• CONDITIONS 04' be
Desired Starting Date timated Time for Completion
Permit to be issued to G S
the holder of Drain -Layer ' s Lic a No. `g3Q Permit will expire thirty
( 30) days ,"-' fter date of issda�nc 'The undersigned' Drain Layer- hereby agre'e.s
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
icen /ed
n Layer
The above named Drain Layer has a vali license issby the State of
Connecticut and has filed a satisfactory bond and insurance policy in the
name of the Town of South Windsor :
. M ng4 t1 o g Dept . Date
Permit Fee Paid $ C Check Number �1•
Connection Change Receipt No . Dated :p�7-Q�
Issued by
INSPECTION
Date work started 4co Z.-9' Date completed
Sufficient notification r e ve , : s
Special Conditio s
v
OF
9 3;(?0 'M APPR
, Inspector Date
C ��
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SANITARY.LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: y-2:7 4'6:: TIME: /O .7O
BY: ✓b-,�'�/ �I�/�G7�iIs� FOR LOCATION: lzry%bai>
DAY INSPEC. NEEDED TIME:
TYPE. OF .INSPECTION:
(. .).. SANITARY/,LATERAL"'- (';PERMIT-:`NG Z } ( : }::. FOQT?NG._DRAIN .
t ( ) EXCAVATION (PERMIT N0 OTHER,
WSRECTION>-REPOFT.
DATE. 2 - S TIME: -.
g ?D INSP:
CONTRACTOR'- ' . t M WEATHER: j o -
WORK- IN PROGRESS:-
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AREA OF CONCERN:
SPECIAL INSTRUCTIONS: