HomeMy WebLinkAboutDrain Layers Permit 16 Drake Court {
y . TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT NO 6283
or
,Pu`rsuant to written application, permission is hereby granted to the
LiXseD.rain La er named herein to, perform the work indicated below ra
?r`` 9L T A ice ` at. pre s s owned ' by ai?S
whose ad-dress is a, .f'c�-�" and To
Lay House Drain, Repair HoVs67Drain, Lay Main, Other ,
for , occupancy or use, with
Family Units , Vith acres . - �
Type of Sewage to lie connected under this permit : SANITARY 'SEWAGE ( ,
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made wfth SDA SCWd* ',ote
Show sketch' of'' proposed;-work or furnish two (2) copies of separate drawings .
OSHA REQUI EME TS MUST BE LLOWE,
SPECIAL CONDITIONS
Desired Start 'n.g.._Date A Estimated Time .for Completion
Permit .to bel issued to 5O hti 5(,- caozes
the holder of Drain Layer's License No. 2,0 Tg3O. Permit will expire thirty
( 30 ) days after date of. issuance. The undersigned ..D'rairi Layer hereby agrees
to all th-e. 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
Lice d Drdby
Layer
The above named Drain Layer has a valid license issu the State :of
Connecticut and has filed a satisfactory bo d nd insurance policy in the
name of the Town of South Windsor:
EnUme
eer Dept,. Date
Permit Fee Paid $ ZS^�00 Check Nr 06,?O
Connection Charge Receipt No 4ss Dated
Issued by /-
INSPECTION'
Date work started 7— Date completed"
Sufficient notific ceives ; des No
Special Conditions
APPRO
nspector Date
SANITARY LATERAL & EXCAVATION PERMIT
• INSPECTION:REQUEST
DATE OF REQUEST: 6-� - 9jr TIME:
BY:
FOR LOCATION:
.,DAY INSPEC. NEEDED �- � �� TIME
r
TYPE_ OF INSPECTION:
SANITAR-y/LATEllAL (.PERMIT`::NO. Z83 } ( }. FOQT,ING,_D.RAIN:.
EXCAVATION (PERMIT NO. ) ( } OTHER
INSPECTIOIVRE ORT ,
( DATE: 19 �i�`. 9 5' TIME: 9 : 3D INSP:
CONTRACTOR--:' Z:mWERTHER-
WORK IN PROGRESS:, U44-
00,
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: