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HomeMy WebLinkAboutDrain Layers Permit 767 Foster Street TOWN of SOUTH wI N DSOR i DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMITNOW S 1"3:5 9 Pursuant to written application, permission is hereby granted to Licensed a n Layer n med herein to perform the work. indicated: .1elo:w at ��6 0 at premise$. owned .by, whose address is 1-roust-et : '. eh Lay HouAe Drain, Repair House Dran,____,.�ay Main, _�t�ther r3 for bu5t. , :occupancy or use; with Family,--Units, with acres. hype of Sewage to be connecte nder this permit : 3ANIfiWRY,` SEW#t INDUSTRIAL WASTES ':( ) , -OR: ( • ) _ . - :, , . " <�: , ,_ • , . Connection will be' made witho Show sketch-bf pfo'po`sed work o ish, 'two: (�2): cop.ies of sea t; }d k f D HA REQUIREMENTS MUST $E; ' 'SPEC AL CONDITIONS r tw"� r Desired Starting Date. f Estimated 'dime .for r,otnp .etic �s Permit to be issued to the holder of Drain Lay.er'.s License No. Permit w311 a „fr* (30) 'days after date of issuance. The undersigned Drain L,ayex to all the terms .-and conditions. set forth in ,the �3ait ash theti4 ` thereof. Applicant ha$ received Town Perm-it No, a / 2t CHD Permit No. - k Signed The. ..above named Drains haler has a valid licenae`: i,Rsud• t , Connecticut and, has filed sat: s atIt b 'I'd name of. .the Town of South 'Wind"s:ors s im. a 11: DP t �► � r a�,e xir� � ,�y �. ri �?er ?Paid Chec�ls3 tainbe ConCharge Reoei.pt`.�So. INSPECTIQN Date work 'started -Z1� j Date cQp►p),e:tad 1. Special-�nditions: z ' is .i ; APPROVED::., Inspector �t SANITARY LATERAL & EXCAVATION PERMIT INSPECTION REQUEST DATE OF REQUEST: C \t`l TIME: lS po--� BY: kC FOR LOCATION:-- DAY INSPEC. NEEDED �cN� �G�./ TIME:—(?,,cc) AfY1, TYPE OF INSPECTION: ( ) SANITARY/LATERAL (PERMIT. NO. �--�/ ) ( ) FOOTING DRAIN ( ) EXCAVATION (PERMIT NO. ) ( ) OTHER INSPECTION REPORT DATE: — Z/ — 9 TIME• ©j A�yy INSP CONTRACTOR: � f� ;, WEATHER - --WORK IN PROGRESS: AREA OF CONCERN: SPECIAL INSTRUCTIONS: