HomeMy WebLinkAboutDrain Layers Permit 80 Heatherwood Drive v .a' xn:r,..R...,.,,R. .h,+"tafF�anwira••yr, -
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 20, 6296
eA
50 Gv�
. 19�
Pursuant to written lication, permission is hereby granted to the
Licensgd Drain La er nam erein to perform the work indicated below at
at p emises o ned by
whose address is $' an
Lay Hodse Drain, Repair Ouse Drain, Lay Main, ' Other
for occupancy or use , with 5'
Family Units, ith 0 acres .
Type of Sewage to be connected under this ;permit : SANITARY SEWAGE" ,
INDUSTRIAL WASTES ( ) , OR
Connection will be made with 3,
Show sketch of proposed work or furnish two (2) copies f separate drawings .
hI
I
OSHA REQUTR�FME TS MUST BE FOLLOWED
6�lJ
Desired Starting Date S' Estimated Time for Completion
Permit to be ; issued to O�►Z h 'S —1 ✓
the holder of Drain Layer ' s License No. ?c�55 30 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
CH'D Permit No .
Signed' lG�`
i'Ge a Dr Layer
The abovenamed Drain Layer has a vali icen's issu by the State of
Connecticut and has filed a satisfactory bond and insurance policy in the
name of the Town of South Windsor :
Engineerin Dept . Date
-
Permit Fee Paid $ 010 Ch____ Number
Connection Charge Receipt No , * Q � • T
g P t d � -9 2 i
oe
Issued by r 7`a"
INSPECTION
Date work started Date completed 7- Z '7- 73 2
Sufficient notification i ed. —Z7 Yes No
Special Conditions _
A
Inspector D to
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE. OF REQUEST': .J'fJ 7/ TIME r
BY;: FOR LOCATION:
/7
DAY INS'/C. .NEEDED TIME:- 4
. . TYPE`OF 1-NSPECTION:-
i _ ( SANITARY/LATER (' ERMTT: .NO Z`. } ( ; } FOOTING.;DRA,IN,_
( ) EXCAVATION (PERMIT'.NO. ) ( } OTHER
INSPECTIOW REP:OR.T .
DATE:'. TIME: INSP: J �
r
r CONTffACTOR't'
WORK IN PROGRESS: Gk
ol
r ` `
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: