HomeMy WebLinkAboutDrain Layers Permit 135 Heatherwood Driv TOWN OF SOUTH WI N DSOR
a � DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 6073
( �! , 19
Pursuant to written application, permission is hereby granted to the
Licen1ssed Drain Laye na d he in to perform the �ork `Otdicated below� t
z 7 Y . /�'``//Fj'srr., at promisee owned by
whpse address - yj l a to
Lay House Dry n, Rep , . s Drain, Lay Main, Oth r ,
for —� " ; 7 .occ `nc o use with
�;�.a yv� � , f
Family - ,y with acres.
Type of Sewage ,.be connected under this permit : SAN AY SEWAGE
INDUSTRIAL WASTES ( )-,' OR ( ) r
Connection will be made with _Zak
Show sketch of proposed work o.r, ,furnish 'two (2) copies of separate drawig4s`.
O HA REQUIREMENTS MUST F�WED
SPECIAL- CONDITIONS �; 74a
Desired Starting Date Estjn}eted Time for Completion
Permit to be iss"d.:-t•o
the holder of Drain Layer's License No. Permit will expire thirty
(30) days after date of issuz
_k4004/1, The ,undersigned Drain Layer heleeby a�;grees
to all the terms and conditions set . forth�.4d the permit and the reverse side
thereof. Applicant has received Town Per'it` No. and/or
CHD Permit No. /
Signed
r'
g
'Licen d . ra Layer
r �
The above named Drain Layer has a vali license:.ssue by the 'State of
Connecticut and has filed a satisfactory bond and insurance" policy in the
name of the Town ,of South Windsor:
Engineering Dept. Date
Permit Fee Paid Check Number
Connection Charge Receipt No. L-Jy0 Dated /2 - Zy -9 3
Issued by
INSPECTION
Date work started Date completed /�- -
Suffi'cient notificaLlon received: No
Special Conditions
APPROVED:
Inspector Date
c
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: ���� l ��� TIME: /6 'OU Afy-\
BY: l^� �'y FOR LOCATION: j-o4 `J-� v - `k\ ��Occ)
DAY INSPEC. NEEDED 1 Y-\ TIME: J1:00
TYPE OF INSPECTION:
( ✓ ) SANITARY/LATERAL (PERMIT NO. G��'Zj ) ( 1) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: - (o - 54 TIME: � 3 o INSP:
CONTRACTOR: WEATHER: 6L, 3S
WORK IN PROGRESS:
! — m —9 f /d' e 30 ltlD.42 h ,p
V u
Z ;
0
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: