HomeMy WebLinkAboutDrain Layers Permit 35 Heatherwood Drive 5
6356
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
DATE: -- --q 5
Pursuant=to wri n application, p emission is:/ereby gra t d t e Licensed Drain Layer named herein to
perform work at Lot# (? as indicated below, at
premises owned by T YkJ 1 whose address is S and
ay Main ir
occupancy or use, with acres.
Type of Sewage ta:be connected under this permit: SANITARY SbWAGE , f,NDUSTR/AL WASTES!J,
OR!1 Connection will;be made,with ., SD7Z. All
work to be in accordance with Town of South Windsor standards, al/OSNA requirements and;the conditions
indicated on the back of this permit.
Proposed start date / "! `"q 5 Estimated a for comp/etipn_
�
-- Permit is tc be issued to` o --H 05 the holder of Drain Layer's License No.
Only holders of P 1, P7 & W9 /leans s will be issued permit. Permit will.axaire thirty.(M
days after date of issuance. The,undersigned Drai Layer hereby agrees to a//the terms and conditions set
forth in the permit and the reverse side thereof. A16plicant.has ceiv Tom Street;Excavation Permit No.
and/or ConnDOT Permit No.
Signed
' en Drai yer
FOR TOWN USE ONLY
Permit Fee Paid $ Z9-44 (Check No.) E7Pr-4—M—
Y N Connection Charge $ -DD (Receipt No.) Dated �O
Insurance on File (!.lr( J
Bond on File (vr( J This permit is hereby issued to the above named Drain Layer who has a valid
license issued by the State of Connecticut and has on file,satisfactory bond
Premises subject to and insurance in the name of the Town of South Windsor.
Intertown Agreement
Record of Sewer
Assessment ( J ( J Issued by Date /
INSPECTION
Date Work Started 7/--0z_ Date Completed
---Comments
APPROVED
Inspector Date
t
SANITARY,LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
._ DATE,-Or REQUEST: �JoU• I I99S TIME. -a'•00 ptY1
t BY: qC c3 FOR LOCATION: � � Vloo.%QnL*c
Q
DAY INSPEC. NEEDED yv 1 ^a TIME: .
TYPE- OF INSPECTION:
SANITARY'/LATERAL,'(PERMIT::N(} C 65G }` ( ) FOOTING.,DRAIN.
( )` EXCAVATION (PERMIT NO. ) ( ) OTHER
IWECTION, REPORT
DATE:`: ��-D - 9s� TIME: INSP: /31�
COI�TTRACTOK J!7? WEATR -: lw 1:✓�
WORK!.IN PROGRESS:
%' ii 22L . 1/ Z� I /`era i�i�( �f�f ✓ �vl�
Gv9� l7rzY vim'/?-f-Ilo/�% w�T/ �z.:U-.— U
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: