HomeMy WebLinkAboutDrain Layers Permit 219 Kent Lane -�. "._{^+v _ .._ -.e.-.�,�+F. -.- -.. -. .__ "cW;h'.o-• `.�H'+sk.Sfl` `P" ,�S:�j.'�` ��'.. fi t ,j _.-..
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
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DRAIN LAYER'S PERMIT 6051
Pursuant to written app ication, permission is hereby granted to the
Lic nsgd Drai La ye named herein to perform the work indi to below at
at promises owned by �p
whose address is '� C ,"j L / v -,.,-� and to
Lay House Drain, Repair House Drain, Lay Main, Other ,
for occupancy or use, with
Family Units, with 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 separa a Ora ings.
OSHA REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONS
Desired Starting Date Estimate# Time for Completion j -Z, q'1
Permit to be issued to
the holder of Drain Layer's License No. gZ✓91-L1 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
Licensed Drain Layer T�-
The above named Drain Layer has a valid license issued by the State of
Connecticut and has filed a satisfactory bend and insurance policy in the
name of the Town of South Windsor: j
NZ3/93
s
gin ng Dept. Date
Permit Fee Paid $ Chec Number _;�,�6� 7_ jy
Connection Charge Receipt No.
3,� �> ated lI/L�j`7 _
Issued by
INSPECTION
Date work started Date completed
Sufficient notifica n receive es No
Special Conditions
, ,APPROVED:
I Spector Date
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REOUESToG
A A TIME:
DATE OF REQUEST: I��Z3 / � � 'Atir4
BY: JZ A)L� FOR LOCATION:47 3y// 47-JrZAUF
Soo
DAY INSPEC. NEEDED �fIZ3 TIME:
TYPE OF INSPECTION:
( SANITARY/LATERAL (PERMIT NO. FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. } ( ) OTHER
INSPECTION REPORT
DATE: , fr' Z3 TIME: O INSP:
CONTRACTOR: WEATHER: 535
WORK IN PRO RESS: 'sa-14 A
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: