HomeMy WebLinkAboutDrain Layers Permit 36 Heatherwood Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 2 6227
19
Pursuant to written application, permission is hereby granted to the
Lic used Drai Layer named erein to perform the work indicated Belo at
at premises owned by
who a addres is to
Lay House Dr in, Repair Ouse Drain, Lay Main, `'Other ,
for occupancy or use , with I
Family Unit , with J. acres .
Type of Sewage to 'be connected under this permit : SANITAgSEWAGE ( ell,
INDUSTRIAL WASTES ( .) , OR )_
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings .
OSHA REQUIREMENTS MUST E_FD LOWED
SPECIAL' CONDITIONS S
Desired Starting Date /2 `,-2;z Estimated Time for Completion1
Permit to be issued to "a �� Lc+s J
the holder of Drain Layer ' s License No. -Zagg Permit will expire thirty
( 30) days after date of issuance. ' The undersigned Drain Layer hereby agrees
to all the terms and conditions set forth rin the permit and the reverse side
thereof . Applicant has received Town Permit No and/or
CHD Permit No.
Signe°d115�4
ice d Dprin Layer
The above named Drain Layer has- "a vali icense iss ed by the State of
Connecticut and . has filed a satisfactory bond " and insurance policy in the
name of the Town of South Windsor :
/Z/t?"Z4
g rie9vIng Dept . Date
Permit Fee Paid $ Che k Number r`
Connection Charge Receipt No. r Dated
Issued by
INSPECTION
Date work started Z - Z3,9 4-- Date "completed f 2.-2. 7
Sufficient notification—recei"vea : == es No
Special Conditions
APPROVED:
; ' Inspector Date
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE. OF REQUEST: z, - 2-3 9 4- TIME: d' r a d
BY: FOR LOCATION:#9'f f,ili/m1
DAY INSPEC. NEEDED / Zr 2 S -9 ¢- TIME:_
TYPE OF INSPECTION:( �) SANITARY/LATERAL (PERMIT NO. 6 L Z7 ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: / 2 " Z 3 - TIME: 9 L 30 INSP:
CONTRACTOR: WEATHER: S °�
WORK IN PROGRESS: Z.644 CL
s
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: