HomeMy WebLinkAboutDrain Layers Permit 48 Jonathan Lane ���
� 4�a'
Ng 3�°�
s -
Aw
TOWN OF SOUTH WINDSOI
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL! DRAIN LAYER'S PERMIT ' NO 5738
- - 19-9a._
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
Led 4 a rye at premises owned by 1� �1 t e7,1 -
whose ad ress is d"r b,A P f 6 Pi0. and ,to
Lay. House Drain, .Repair House Drain, Lay Main, Other ,
for 5 1 yi -# ` �,h f occupancy or use, with
Family Units , with acres.
Type of Swage to be connected under this permit : SANITARY SEWAGE
INDUSTRIAL WASft'S ( ) , OR ( )
Connection will be made with I/('.,
Show sketch of proposed work or furnish two (2) copies of separate drawings.
19_
-- SPEC-IAL CONDITIONS
Desired Starting. Date 4 . .-2,L. Estimated Time for Completion
Permit to be issued to L — e- litc .
h.
the holder of Drain Layer's License No. I .. Permit will expire thirty
(30) days ,after ,date of issuance. The undersigned Drain Layer hereby agrees
to all the tents and conditions set forth in the permit and the reverse side
thereof. Appl.4cant has received Town Permit%No,,. p (6 and/or
CHD Permit N*o. ;.Signed (4,ljilYi
/�icens d Drain Layer
The above named Drain Layer has a valid �Xcense issued by the State of
Connecticut and has filed a satisfactory bon /and- insurance policy in the
name of the Town of South Windsor:
Engineering Dept. Date
Permit Fee Paid $ Check Number ���
Connection Charge Receipt No. Dated 2--/y-
issued by
INSPECTION
Date work started Date completed_ "�2
Sufficient notification receives: 'es No
Special Conditions
Of
— -- APPROVED:
Z _
Inspector Date
829 id0 -
BOND TOWN OF SOUTH WINDSOR - "
FAm't
't i
q. PUBLIC WORKS DEPARTMENT Date -4 - -7 '"
TOWN HALL
File 1540 SULLIVAN AVENUE Permit No.
SOUTH WINDSOR, CT 06074
Date of Expiration Permit Expires
APPLICATION FOR PERMIT
FEE-#qAA r'
Name and address of applicant JOHN IJMBERglR INC. phone No. = -
Location of proposed work Jqpatria.n ane
Describe fully nature of permit requested a e.. a,_ .
Insurance on file with Town yes no Date policy expires
c Name of Insurer
o Approximate time for completion Desired starting.date
Call before you dig ticket No.
U
Q. Show sketch of proposed work or furnish 2 copies of separate drawings
a
w
0
c
0
O
a
a.+
U
a
E
0
U
O
y
O
td
U
a
a Applicant is responsible for contacting the Police Department and CALL BEFORE YOU DIG.
Q
I agree to furnish to the Town of South Windsor the amount of bond or deposit required and to
reimburse the Town of South Windsor for any expenses incurred by the Town for maintenance or repair
work in connection with this permit and that I am familiar with and will abide by the rules and
regulations for permits as outlined in the Town of South Windsor's (Pavement Cut Regulations.)
Signed
APPROVED. DATE APPROVED: DATE '
Supt. of Highways i =f ; Town Engineer
FOR INSPECTOR: Date work started Date completed
Sufficient notification received: yes no Type of repair: Perm. Temp.
Unusual conditions encountered
Material slips attached: yes no Dated for Permanent repair
Signed
Inspector
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT ' 0 5712
2 - a6 191,)-
Pursuant to written application, permission is hereby granted to the
Licensed Drain La er named herein to perform the work indicated below at
a /_a. at emises owned by /,) ��c ocvas/.
whose address is nr n and to
Lay House Drain, _.,, Repair Hous Drain, Lay Main, Other ,
for occupancy or use, with
Family Units with acre .
Type of Sewage to be Conn cted under this permi SANITARY SEWAGE ( ) ,
INDUSTRIAL WASTES ( ) , OR ( ) f I/C
Connection will be made with
Show sketch of proposed work r furnish two ( ) c pies of separate drawings.
I-
--SPECIAL CONDITIO S
Desired Starting Date _ a 7_ -9a Estimated Time for Completion
Permit, to be issued to
the holder of Drain Layer' s icense No. gj,,F¢((� Permit will expire thirty
(30) days after date of is u nce. The undersignedDrain Layer hereby agrees
to all: the terms and condit ns set forth in the permit and the reverse side
thereof . Applicant has received Town Permit No--. and/or
CHD Permit No.
Signed
icens Drain Layer
The above named Drain Layer has a valid 1 cense issued by the State of
Connecticut and has filed a satisfactory bon and insurance policy in the
name of the Town of South Windsor:
Et i eering Dept. Date
7
Permit Fee Paid $ 2 5•Q YL ILZ-
Check tuber
Connection Charge Receipt No. z � Dated
Issued by
INSPECTION
Date work started Date completed -
Sufficient notification received: Yes No
Special Conditions
- -APPROVED:
Inspector Date