HomeMy WebLinkAboutDrain Layers Permit 45 Farm Brook Lane 01
$ 6389
s TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU.OF POLLUTION CONTROL
DRY LAYER'S:PFIT
DATE:
Pursuant to written appl/cstion, permission is hereby. granted to the Licensed Drain Layer named herein to
perform work atf Lot#_ as/nd/cated below, at
Premises owned byi9c�riA. � whose address is. and
to Lay House'Drain X , Repair House Drain , Lay Main Otherfor
occupancy or use; with acres.
Type of Sewage to be connected-under this Permit.- SANITARY SEWAGE.^ INDUSTRIAL WASTES(1,
OR (1 Connection:will be made with Al/
work;to be in accordance with Town-,of South Windsor standards, all OSHA requirements add the conditions
F indicated on the back of.this permit.
Proposed start date � ff1 �i Estimated dMe for completion. Ky&,C
Permit is ltqbelssued to dre_drie/h n r��.,l6y the holder of Drain Layer's Lioense No."
n/y holders of P1, P7 & W9 /ice ses_weued permit, . Permit.will exvre thirty (3 )
days after:date of,_rasuancg. The undersigned Drain Layer hereby agrees to all the teams and conditions set
in in the permit"and the reverse side thereof. Applicant has received Town Street Excavat/on Permr7t No.
Xd d 9/7 and/or ConnDOT Permit No.. _ 001, -
Signed
Licensed Offin Layer
FOR TOWN USE OK Y
Permit Fee Paid$ c2S=°a (Check No.) Cost-,
Y N Connection Charge S ".EC]o.00 (Rece/pt No.) L M3 Dated FBI-ViG
Insurance on File 4(
Bond on.File This permit is hereby issued tv the above named Drain Layer who has a valid
license lssqed by the SteWo of Connecdzit and has on file,satisfactory bond
Premises subject to and insurance in the name of the Town of South Windsor.
Intertown Agreement ( 1 (ty' -
Record of Sewer y,,,
Assessment ( 1 ( 1 /slued by DateZ4j
-•-- --IlaiS1'�CTION :' _
Date Work Started 3 //—rG Date Completed,
amments __ .. -- - - - - --
APPROVED:
Inspector Date
5AN1 1AKY LA1 h KAL & tRVAVATION PEKMI I
INSPECTION REQUEST
:- DATE OF REQUEST:— ���, TIME:
BY: FOR LOCATION:_-t--F 6,'�
DAY INSPEC. NEEDED htc�
"� 1 TIME:—
TYPE OF INSPECTION: /yiai✓`3 .��-qG 9 3a
( SANITARY/LATERAL (PERMIT NO. 3 ) (,>C_) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
FE
P
INSPECTION REPORT
DATE: 'rl_ �� TIME: INSP: f�T
CONTRACTOR: �� t/G-� '¢ ' WEATHER: /ov i� v
WORK IN PROGRESS: iy �117 / � 2v � �,�v ST �• � ~'
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AREA OF CONCERN: ,
SPECIAL INSTRUCTIONS: