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HomeMy WebLinkAboutDrain Layers Permit 59 Heatherwood Drive (2) TOWN Of SOUTH WI N DSOR r DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT N2 6106 11_��1L'�11.�5 cis 1�F , 19YY Pursuant to written application, permission is hereby granted to the Li�ce�' sed Drain L ye ,nam d herein to perform the work indicated below at L �F A X; at pre ises owned by ,� /f,�T I0/Xq whose ad ress is 44"rtf a d to Lay House Drain, RepairHouse Drain, Lay Main, Ot er �, for -ABI occupancy or use, with Family Uni s, with acres. Type. of Sewage to be connected under this permit : SANITARY SEWAGE ( ; INDUSTRIAL WASTES ( ) b OR ( )' ., - Connection will be made with �_f,�,� _35- ,�f!✓ Show sketch of proposed work or furnish 'two (2) copies of separate drawings. OSHA REQUIREM b eTS ST BE�FOLLOWED SPECIAL CONDITIONS jar) L3 Dull' sired Starting Date y � �--Estimated Time for Completion Permit to be issued to T©h✓! �c � �J.�.$ e holder of Drain Layer's Mcense No. 2�007 p Permit will expire thirty (30) days after date of issuance. The undersigned Drain Layer hereby agrees to all the terms and conditions set - forth in the permit and the reverse side thereof . Applicant has received Town Permit No. and/or_. -CHD Permit No. SignedA ice edZed ain Layer The above named Drain Layer has a v icen a is by the State of Connecticut and has filed a satisfactory bond and insurance policy in the name of the _Town of South Windsor: 5 4--g4-- Engineering Dept. Date Permit Fee Paid $ �SoO Check Number Connection Charge Receipt No. y/_LL__� Dated -/-/Q-Q,y ' Issued by A:. INSPECTION Date work started to completed 9d, Sufficient notification, r c vea: Aj�,;�es No cial Conditions , APPROV . Inspector Date SANITARY LATERAL & EXCAVATION PERMIT INSPECTION REQUEST DATE OF REQUEST: 4 2q-- j9' TIME: 2, - 9 S'- z • 9 ¢ BY: U n ---omf A FOR LOCATION: O_ DAY INSPEC. NEEDED s^ 2 -9 TIME: /® ,` 3ez &.,44_ TYPE OF INSPECTION: ( X) SANITARY/LATERAL (PERMIT NO. ) ( ) FOOTING DRAIN ( ) EXCAVATION (PERMIT NO. ) ( ) OTHER INSPECTION REPORT DATE:- TIME: l D ! 3a INSP: CONTRACTOR: WEATHER: sS o WORK IN PROGRESS: VAdl AREA OF CONCERN: SPECIAL INSTRUCTIONS: