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HomeMy WebLinkAboutDrain Layers Permit 98 Heatherwood Drive N! 6342 TOWN OF SOUTH WINDSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT DATE: ZO hereby granted to the Licensed Drain Layer named herein to Pursuant to Wr1tvApI, izon, ermisslon is perform work at _ _/I 1 r Lot# 2-- as indicated below,a premises owned by C-A whose address is and occupancy or use, with acres. Type of Sewage to be.,connected'under this permit., S.AN/TARY SEWAGE(KJi•%NDUSTRIAL WAW)'All OR(1 ^� Connecdon wi!(be made with rD li. work to be;in accordance with Town of South Windsor standards, a/l OSHA requirements ohdl the condiddns indicated on the back of thinpermit. Proposed start date Estimated time for completion 1 D Permit is to be issued to;; V'�'S� 'J'thd of Drain Layar'3� License Nv. Z01as30 Only ho/demof P1' P7 & W9 licenses will be issued permit: . Permit wiil exn/re thirty (30) days after date of issuance.. The undersigned Drain Layer hereby agrees to"a//the terms and condl#ons set. forth in the permit and the reverse sjde.thereof. Applicant has received.Town Streat Excavation Permit No. and/or connDOT Permit No. _ Signed Lice Or yer FOR TOWN USE Oft Y Permit Fee Paid S `©U (Check No.) Y N Connection Charge $ (Receipt No.J Dated Insurance on File (✓f(1 Bond on File This permit is hereby issued to the above named Drain Layer who has a valid license issued by the State of Connecdcut and has on Ne,satisfactory bond Premises subject to and insurance in the name of the Town of South Windsor. Intertown Agreement Record of Sewer Assessment ' Issued by Date �p INSPECTION Date Work Started f c7- 3-- 95 Date Completed -- -- Comments APPROVED: zo- =95 Inspector _ Date SANITARY LATERAL.& .EXCAVATION PERMIT INSPECTION REQUEST DATE OY REQUEST': 03- Q 5� TIME:: BY: FOR LOCATION: DAY INSPEC. NEEDED �O �U3��'S' TIME: TYPE OF INSPECTION: �3y ( /� ) SANI.TARY/LATERAL'-(PERMIT7."N( }., ( .. }• FOQTING:.,DRAIN,, EXCAVATION (PERMIT NO. ) ( ) OTHER INSPECTION+ REPORT•--., DATE- /� - 3_ �� TIME: Z t O INSP: CONTRACTOR::- AA WORK .IN. PROGRESS: w AREA OF CONCERN: SPECIAL INSTRUCTIONS: