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HomeMy WebLinkAboutDrain Layers Permit 7 Drake Court TOWN OF SOUTH WI N DSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT 2 6061 Pursuant to written application, permission is hereby granted to the Licensed Drain Layer nam d here n o perform the work indicated below at 7, 3 P Akz - e,;b4lt D r emis es owned by whose address is a' and to Lay `-House Drain, Repair H use Drain, Lay Main; Other , for occupancy or use, with ° Family Units, w th acres. . Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ) , INDUSTRIAL WASTES ( ') OR Connection will, be made with I DR 3S S�'�VtpY �, Show sketch of proposed= work or furnish 'two (2) copies of separate drawings`. OSHA REQUIREMENTS MUST BE FOL OWED SPECIAL CONDITIONS. ,p &,? -Q«S � b.e .6©/�a ,�, Desired Starting Date / z -1)� 173 Estimated Time for Completion1 Permit. to be issued to � v11/n :SQ (" 6?0c''-s the holder of Drain Lager's License No. Z0,fr30 Permit will expire thirty (30) days after date of issuance .,;. The undersjgned .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. !/.4��L� and/or CHD Permit No: Signed 2 Div Linen e� Dr In Layer The above .named Drain Layer has a valid license issued by the State of Connecticut and has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor: yew Engineering Dept. Date Permit Fee Paid Check Number �j CI /J © �• Connection Charge Receipt No. A/ X/Gx Dated \2\—\\�'�j Issued by t INSPECTION Date work started �pz Date comp eted Z �� q _ Sufficient motifica�ion rece e : � es o Special Conditions loe APPROVED: nspector Date SANITARY LATERAL & EXCAVATION PERMIT INSPECTION REQUEST DATE OF REQUEST: TIME: // c' Oc , /fijr BY: FOR LOCATION: DAY INSPEC. NEEDED TIME: `i B O '4 M , TYPE OF INSPECTION: ( O`) SANITARY/LATERAL (:PERMIT NO.�O- (� 1 ) ( ) FOOTING DRAIN ( �} EXCAVATION (PERMIT NO. ) ( ) OTHER INSPECTION REPORT - e DATE: 2 - ,� - / �3 TIME: .1/ 0 0 INSP: iG CONTRACTOR: WEATHER: WORK IN PROGRESS: C, 0. YLAC ono a W AREA OF CONCERN: SPECIAL INSTRUCTIONS: