HomeMy WebLinkAboutDrain Layers Permit 89 Heatherwood Drive Vie
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 6 0 6
suant, to written application, permission is he oy rased to the
*r $ f
Lc/e, ed 7?tlDrain La r named�herei t, erform the work f"trdicaC`e below, at
--- ' - . v ! c� �' UC`+' remi es owned by v - o S
n
w} ose addielifi is wi - e7 v J and. to
Lay douse rain,, 4.pai.rr se/ Drain,., Lay Main, 0 er
forZ'/oecup or base, th S,
Family Un t*1i_. a p4fs•
Type of Sewage 't 'be connected under this permit: SAVk.A SEWAGE ( ,
INDUSTRIAL WASTES
f Connection will be made with
Show sketch of proposed work op,jv_tnish 'two (2) copies of separate drawings::
OSHA REQUIREMENTS WST BE FOLL WED rf
SPECIAL CONDFTIONS
Desired Starting Date d EstimatedlT £g•;F, Completion
Permit to be issuead . o /�1✓1 L a LI)46
the holder of Drain Layer's -L-i¢ense No. zjg4W3f Permit will expi F_, hirty
(30) days after date of iss n'`ae.. JThe ned Drain Layer here iy #green
to all the terms and conditions set . fortX,;t* .. the permit and the reverse side
thereof . Applicant has r`e,ceived 'Town Permit No. and/or
CHD Permit No.
Signed
License rai ayes
The above named Drain Layer has a vali� license issued by the State of
Connecticut and has filed a satisfactory bond and insurance policy in the
name of the Town of South Windsor:
(4, O Z-/
Engineering Dept. Date
Permit Fee Paid $ 5�. flu Check Number
Connection Charge Receipt No. Dated f
Issued by
INSPECTION
Date work started �y-�g _,9 /Date ,completed
Sufficient notification receiv : es No
Special Conditions
APPROVED:
Inspector Date
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: 4/ TIME:
BY: 1215�16LW-- FOR LOCATION:
DAY INSPEC. NEEDED y' Zp-- 94� TIME: %
TYPE OF INSPECTION:
( v) SANITARY/LATERAL (PERMIT NO. FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( } OTHER
INSPECTION REPORT
DATE: �/ - w� TIME: /� 3 U INSP: // •�
CONTRACTOR: j WEATHER:
WORK IN PROGRESS:
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: