HomeMy WebLinkAboutDrain Layers Permit 2270 TOWN OF SOUTH 1
W NDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 6050
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Pursuant to written application, permission is hereby granted to the
Licensed Dr in ayer n .r aped herein to perform the work ind to be ow at
� at p emises owned by l /� ��.��
whose address is C Liu xj,7G - and to
Lay House Drain, Repair HousdDrain, Lay Main,- Other ,
for occupancy or use, with
Family Units, with acres.
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Type of Sewage to be: connected under this permit: SANITARY SEWAGE ,
INDUSTRIAL WASTES ( ) , OR
Connection will be made within
Show sketch of proposed work or furnish 'two (2) copies of separate drawings.
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OSHA REQUIREMENTS MUST BE FOLLOWED
SP CIAL CONDITIONS
Desired Starting Date2 3Estimated Tim for Completion /,X- Z/
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Permit to be issued to
the holder of Drain Lay is License No.' s ermit 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.
Signed . -
icensed Drain 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:
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Engineering Dept. Date
Permit Fee Paid $ � - Check Numbers
Connection Charge Receipt No. y919/ Dated
Issued by z0 d1!
INSPECTION
Date work started Date .cs m� pleted �f/z9�93
Sufficient notification rece ve v es Now
Special Conditions
APPROVED:
sp c r Date
SANITARY LATERAL & EXCAVATION PERMIT
\ INSPECTION REQUEST
DATE OF REQUEST:�\ \`'�q�`�� TIME: \ Q 2_6
BY: �� ��,r�j��- FOR LOCATION:
DAY INSPEC. NEEDED TIME: 0
TYPE OF INSPECTION:
( SANITARY/LATERAL (PERMIT NO. ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION"EPORT
DATE: TIME: INSP:�G��
CONTRACTOR: ��1� 77_ WEATHER: eteyQ
WORK IN PROGRESS: 7z_'57;Jc,4 _-e�zl6r—
110AMZ&Zr_Z Ale U SA s S/
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• D1,tJ7- Ay- ysE 7Z) 5;6 / 1,1� , rcJf /A-) . p�A:�ds
AREA OF CONCERN: f �,� G x O/V 7 AweW'
SPECIAL INSTRUCTIONS:
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: 11-/7 ` /,Z TIME:
BY: FOR L 0 C A T ION: 7- Z 70 4.
DAY INSPEC. NEEDED TIME:
TYPE OF INSPECTION:
( ) SANITARY/LATERAL (PERMIT. NO. �C��0 ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: TIME: INSP:
CONTRACTOR: WEATHER:
WORK IN PROGRESS:
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: