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Home My WebLink AboutDrain Layers Permit 12 Heatherwood Drive TOWN OF SOUTH WI N DSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYERS PERMIT Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at Z- 7 s at premises owned by ,-s whose address is to Lay House Dr in, Repai House Drain, Lay Main, Other , for occupancy or use, with Family Unit , with 3 acres. Type of Sewage to be connected under this permit : SANITARY SEWAGE ( , INDUSTRIAL WASTES ( ) , OR ( ) Connection will be made with Show sketch of proposed work or furnish two (2) copies of separate drawings. SPECIAL CONDITIONS OSHA REQUIREMENTS MUST BF� FOLLO ED . �� S►��'�S -{� ,��0// f'1 Desired Starting Date 2- -- Estimated Time for Completion G Permit to be issued toljr/` G�C�tU� the holder of Drain Layer's License No. 4,1f g'3©. 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 CHD Permit No. Signed // Liceneq d D`, in Layer The above named Drain Layer has a vali4d licenee issued by the State of Connecticut and has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor: �7 Engineering Dept. Date Permit Fee Paid $ 71l� , Check Number 7 �/ Connection Charge Receipt No. Dated Issued by INSPECTION Date work started Z / 7- Date completed Sufficient notificat ion recelvee : es No Special Conditions APPROVE Inspector Date SANITARY LATERAL & EXCAVATION PERMIT INSPECTION REQUEST DATE OF REQUEST: 2.r / 7- 7 -. TIME: BY: p FOR LOCATION: DAY INSPEC. NEEDED -/ �� TIME: � . TYPE OF INSPECTION: l ( ,() SANITARY/LATERAL (PERMIT NO. b© �o ) ( ) FOOTING DRAIN ( ) EXCAVATION (PERMIT NO. ) ( ) OTHER INSPECTION REPORT DATE: 2r - / `7- �- TIME: 11" Q'd - 2 : ©d INSP: CONTRACTOR: /VI WEATHER: l �" 3s o ^l- WORK IN PROGRESS: Z - / T 9 4- O ZJ 2 z. c C4pAA/A-i--44� 2 la o roY I I -2- _ 2. 2 r lz lv-�L I AREA OF CONCERN: e SPECIAL INSTRUCTIONS: