HomeMy WebLinkAboutDrain Layers Permit 19 Diggins Court TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 6 019
19
Pursuant to written application, permission is hereby granted to the
L e�}s;� Drain Layer name herein o perform the work indicated below at
J
�#Aq Vat premises wn d by
whose addre is .� d✓
Lay House Drain, Repa Ot
ouse Drain, Lay Main, a tg
for er ,
occupancy or use, with
Family Units with acres.
Type of Sewage to be connected under this permit : SANITARY SEWAGE
INDUSTRIAL WASTES ( ) , OR ( ) -
Connection will be made with
Show sketch of proposed work or furnish 'two (2) copies of separate drawings.
OSHA REQUIREMENTS MUST BE POLLO ,
SPECIAL CONDITIONS 5
Desired Starting Date 3 Estimated Time for Completion
Permit to be issued to '3i Gr�j�c,g
the holder of Drain Layer's License No. 3_cWk 3� 0 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.
Signe?id
Licen d Dra n ayer
The above named Drain Layer has a va licen issued -by the State of
Connecticut and has filed a satisfactory bond and nsussued policy St the
name of the Town of South Windsor:
Eng rleering Dept. Date
Permit Fee Paid $ �3' Check Number A
Connection Charge Receipt No. f'� �►�7� 1D ted->�
Issued by j`61 13 /4,
INSPECTION
Date work started Date completed
Sufficient notification receive :',-es No
Special Conditions
APPRqVDA
Inspector Date
x•r 77f= e7 A
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
/
DATE OF REQUEST: �p! TIME: 6 O /%,v
B Y= \I �3 FOR LOCATION: 1-or I&& F.
'DR
DAY INSPEC. NEEDED 10 b19 3 /
TIME:
TYPE OF INSPECTION:
( too< SANITARY/LATERAL (PERMIT NO. D �9 ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: 16 TIME: ,or d INSP•
CONTRACTOR: TM C ) WEATHER: , „ °
WORK IN PROGRESS:
�&M
loll
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: