HomeMy WebLinkAboutDrain Layers Permit 323 Felt Road �'; r -��.. .�p.-..,,o...+�'++w'l+ra's'4Fy+R$ �"+xt• �L'j rkk`+ S_'Y'Y`Y -'��-•✓�Y-i'�, 4�_a" 7 .a*,q :. p,: '.AIT,fX 3.,4. j - ,.. :7-•.
6365
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
DATE: /i/�/S/9 67
Pursuant to written application,'
,.Rermission is hereby granted to the Licensed Drain Layer named herein to
perform work at 32 3 f PI' 1" �� _ S 4✓ , Lot# ' as indicated below, at
premises owned by t}vP✓y ST rAu..,! whose address is and
to Lay House Drain - 'Repair House Drain , Lay Main , Other , for
occupancy or use, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE(), INDUSTRIAL WASTES(1,
OR f 1 —j&-td rwlT �gl 9r Connection will be made with (c'Ayr . A//
work to be in accordance with Town of South Windsor standards,a//OSHA requirements and the conditions
indicated on the back of this permit.
Proposed start date _ XZ96 Estimated.time for comp/edon
Permit Is to be issued to W,c` j io je�&-L the holder of Drain Layer's License No.
.94* 36-3 Only holders of P1,0& W9 licenses will be issued permit. Permit will expire thirty QQJ
days after date of issuance. The undersigned Drain Layer hereby agrees to all the terms and condXons set
forth in the permit and the reverse side thereof. Applicant has received Town Street Excavation Permit No.
All4 and/or ConnDOT Permit No. _
Signed r
Licensed Drain Layer
FOR TOWN USE Oft Y
Permit Fee Paid$ �1� �
(Check No.) Z. �
Y N Connection Charge $ G -y Y,--(Receipt N5.) !�Z�4 Dated
Insurance on File ()4( )
Bond on File 09-! 1 This permit is hereby issued to the above named Drain Layer who has a valid
Ikense issued by the State of Coeuwdbut and has on file, s6ftfactaty bond
Premises subject to and insurance in the name of the Town of South Windsor.
lntertown Agreement ( 1 O4!
Record of Sewer
Assessment Issued by _ 3� Date //"'Z6
INSPECTION _.
Date Work Started bate Completed //. Zi
APPROVED
Inspector Date
d �
SANITARY. LATERAL..& .EXCAVATION PERMIT
INSPECTION_REQUEST
DATE''OF:.REQUEST` � TIME.::.
v BY: FOR LOCATION: 3z3 t=G7�%l2U/�i�
a DAY INSPEC. NEEDED //—Zo-95 TIME:
TYPE OF "INSPECTION:
SANITARY/tATERAt`.- PPS';NO-'!. Y . FOOTING,--DPi;IN;.
( j EXCAVATION (PERMIT NO. j ( ) OTHER
INSPECTION-REPORT
F DATE.: //� Z/ - 5 TIME: INSP:
CONTRACTOR.-_ WEATHER:. �J y
WORK IN- PROGRESS:
..L2��Z�1 �� 1/��lT lZ-i�1il�IDr/i�T� - ✓Q�-iGd�.�
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: "