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HomeMy WebLinkAboutDrain Layers Permit 108 Heatherwood Driv TOWN OF SOUTH WI N DSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT 6 196 Pursuant to written application, permission is hereby granted .to the Te sed Drain Layer name4 herein to perform the work indicated •below at at premises owned whose address is !o ra he%-z d to Lay Mouse Dr in.v, Repair House Drain, L"Ma Othe for occupancy or use, with Family Units , it acres. Type of Sewage to be connected under this permit : SANITARY SEWAGE ( , INDUSTRIAL, WASTES ) , OR ) Connection will be made with za - Show sketch of proposed work or furnish 'two (2)" copies of separate drawings. " OSHA PMOUIREM N 'S kjUSM.:, LLOWED SPECIAL�. CONDI'TIONS Desired Starting: -Date ..- $'-� Estimated Time for Completion Permit to be issued to the holder of Drain Layer's License No 3C' Permit will expire thirty (30) days after date. of issuance. The undersigned Drain Layer herwb agrees to all the terms and conditions set . forth in the p.ermit:. and the revora,e id:q thereof. Applicant has received Town Permit No. andjor: CHD Permit No. Signed �sv Lic. sed D in Layer The above named Drain . Layer. h.as a valid lice se iss edby .the. State-.Qf Connecticut and has filed a satisfactory Lond-and insurance policy in.-the, name of the Town of South Windsor, gin ing Dept. Date ; Permit Fee Paid $ ,a6.Q© Chec umber 1eq$ , Connection Charge Receipt. No, y � Dated Issued by INSPECTION r . . .:., . Date work started S_ yz Date completed Sufficient notificacion rece e : es No .- Special Conditions " .. APPROVED* ��� •^ Inspector SANITARY LATERAL & EXCAVATION PERMIT INSPECTION REQUEST DATE OF REQUEST: 10 7 _ 2 TIME: f` Q a BY; FOR LOCATION: Q DAY INSPEC. NEEDED TIME: TYPE OF INSPECTION: ( SANITARY/LATERAL (PERMIT NO. ) ( ) FOOTING DRAIN ( ) EXCAVATION (PERMIT NO. ) ( ) OTHER INSPECTION REPORT DATE: TIME: J/• O d INSP: CONTRACTOR: WEATHER: ° WORK IN PROGRESS: ee-A i AREA OF CONCERN: SPECIAL INSTRUCTIONS: