HomeMy WebLinkAboutDrain Layers Permit 498 Ellington Road .x.
TOWN OF SOUTH W I N DSOR
DEPARTMENT OF PUBLIC WORKS_
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMITN GO
March 28 . 1995
Pursuant to written application, permission is hereby granted to the
Licensed .Drain Layernamed herein to perform the work indicated below at
498' Ellington Road s at premises owned by joseph Elmore
whose address is 498 Ellington Road - South Windsor and to
Lay House Drain,, X Repair House Drain, Lay Main, Other
for residential occupancy or use, with -N/A
Family Units, with A acres .
Type of Sewage to be connected under this permit : SANITARY SEWAGE (X ) ,
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with 6" PVC
Show sketch of proposed work or furnish two (2) copies of separate drawings.
See attached sheets.
OSHA REQUIREMENTS MUST BE FOLLOWED �,3i 30-7 3
SPECIAL CONDITIONS
Desired Starting4; 00-9541;7 ,.F imax.ed�J, a for Completion 1 day
Permit to be issued to Violette Silvester & Sons, Inc.
., holder of Drain Layer ' s License No. P206440 Permit will expire thirty
days after date of issuance. The undersigned Drain Layer hereby agrees
11 the. terms and conditions set forth in the permit and the reverse side
eof . A Ie
pp. int has received Town Permit No . and/or
CHD Permit '— }Ar4,T-errc
1
C_
�; a�-t'h Signed Licensed Drain Layer
The`lbo edlsbrain Layer has a valid license issued by the State of
Connecticst ai s fled a satisfactory bond and insurance .policy in the
name of theme" Town _? outh Windsor :
Engineering Dept. Date
Permit Fee Paid $ 35 .00 Check Number
Connection Charge Receipt No. CG`'SO Dated q5
Issued by
INSPECTION
Date work started Date completed
Sufficient notificat13% eeceive : Tes No
Special Conditions
77777
L--"APPROVED: �lTL
Inspector Date
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: TIME:
BY: ,'��(,� FOR LOCATION:
DAY INSPEC. NEEDED /T 3 3i-�'�� TIME: /� «
TYPE OF INSPECTION:
( �) SANITARY/LATERAL (PERMIT NO. 5� ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: %le/ TIME: INSP:
CONTRACTOR: WEATHER: /��
WORK IN PROGRESS: 7
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: