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HomeMy WebLinkAboutDrain Layers Permit 11 Diggins Court r. TOWN OF SOUTH WINDSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL _ DRAIN LAYER'S PERMIT „ 6 143 - 6 Pursuant to written application, permission is hereby granted to the Licensed ra 'n. Layer named herein to perform the work in Gated: below at p m ses ow e byj w- os address 2 !7�'1 , , to Lay House Dra n, Repair Wduse ,Drain,` Lay Main, Other" for occupancy or use, with i Family nits with acres. Type of Sewage to be connected under this permit: SANTTARY SEWAGE ( INDUSTRIAL WASTES ;100� OR ) Connection will be -made with Show sketch of proposed-work or furnish 'two (2 copies of separate drawings. OjSHA REQUIREMENTS UST ML,�LQWED SPECIAL CONDITIONS IV Desired Starting Date - -- Estimated Timefor Completion , Permit to be issued to '�► CAS the holder of Drain Layer ' s Lich-No. $g' p Permit- 'ill expire thirty (30) days -after date of is-s'uance. The undersigned Drain 'Ifayer hereby agrees to all the terms and conditions set forth in the ,permit acid the .reverse side thereof. Applicant has received Town Permit No. and/or, CHD Permit No. Signed Li ens rai a y e r The above named Drain 'Layer has a vali license ssue b y .the State of Connecticut and has filed a satisfactory bond and insurance ,policy .in the name of the Town .of 'South Windsor _- _ Engineer ng Dept. Date Permit Fee Paid $ Goo , © O Check Number Q,5 ,77 �p�,,,, Connection Charge . Receipt No. +-4 7 Dated Issued by G � INSPECTION Date work started 7, 42 - Date completed `-�� g -- Sufficient notificaLIT Lucelv�e es No Special Conditions 'APPROVED: . Inspector Date SANITARY LATERAL & EXCAVATION PERMIT INSPECTION REOUEST DATE OF REQUEST:_ ` Ql 9L TIME: 7 BY' FOR LOCATION: .M. DAY INSPEC. NEEDED - TIME: CJ a A TYPE OF INSPECTION: /le" ( SANITARY/LATERAL (PERMIT NO. �. ) { FOOTING DRAIN ( ) EXCAVATION (PERMIT NO. ) ( ) OTHER INSPECTION REPORT DATE: - 8,-9 4- TIME: •60 1 2.`a 0 INSP: CONTRACTOR: WEATHER: toi� WORK IN PROGRESS: AREA OF CONCERN: SPECIAL INSTRUCTIONS: