HomeMy WebLinkAboutDrain Layers Permit 1437 Main Street - - -- TOWM=--=OF SOUTH=1�IND l - -- - -- -- - - --_
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
— -- — DRAIN-LAYER'S"PERMIT
. 19
Pursuant to written application, permission is hereb grant d to the
Licensed Drain Layer named herein to perform the work indicated below at
.7- 7 !'YI�Q 1A,1 S at premises owned by CRA► ► _ i,,,-r�l�
whose address is / 3 7 �A ) S'7 and to
Lay House Drain, �,. Repair House Drain, Lay Main, Other ,
for F /,� 1, __occupancy or use, with
Family Un tY `s, 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 urnish 'two (2) copies of separate drawings.
C r 7-Y 4JA.-rL-, T� "3t=
�~ OS RREQUIREMENTS MUST BE FOLLOWED
.SPECIAL CONDITIONS
Desired Starting Date r Es to Time for Completion 7
i
CA
Permit to be issued to
It _,�
the holder of Drain Layer's Licens No.. 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. Applic nt has received Town Permit No. and/or
CHD Permit No.
SignedA Vz-,y/X A
ce seta' D Layer
The above named Drain Layer has a valid l cense is ed by the State of
Connecticut and has filed a satisfactory bon land insurance policy in the
name of the Town of South Windsor:
/reli19
ng nee "i Dept . Date
Permit Fee Paid $ 43, .00 Chec N ber _ IQ54
Connection Charge Receipt No. Dated—,O,}1/q�r�.C�
Issued by < 3//4
INSPECTION
Date work started �' s,/ Date completed
Sufficient notification receivea 's"�yes No
Special Conditions
APPROVED:
Inspector Date
SANITARY LATERAL & EXCAVATION PERMIT
/ � ,/ INSPECTION REQUEST
DATE OF REQUEST: 3 6`�/J'1 -- TIME: ! NN
BY: // idl W AS FOR LOCATION: 143 —
DAY INSPEC. NEEDED 3J/� ¢ TIME: A-;rj;�: Z- jQ A—;-,-i
TYPE OF INSPECTION:
( k, SANITARY/LATERAL (PERMIT NO. D ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: 3 TIME: INSP:
CONTRACTOR: GC ll � C - % WEATHER: 1L"/e-- r
WORK IN PROGRESS :
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: