HomeMy WebLinkAboutDrain Layers Permit 381 Miller Road (2) TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
A 7� DRAIN LAYER'S PERMIT 6010
7
1993
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated below at
at premises owned by 1�a,�f, 4 ��sncf
whose address is SOU 1 T and to
Lay House Drain, Repair House Drai , Lay Main, - - Other ,
for occupancy or use, with
Family Units, with Z; 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.
f1
SPECIAL., CONDITIONS OSHA REQUIREMENTS MUST BE FOLLOWED
Desired Starting Date -2- Estimated Time for Completion.
Permit to be issued to -eck YR6:4: .vsW7
the holder of Drain Layer"s License No. ��,gSC�l� 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. 1
Signed
Licensed Drain Layer
The above named Drain Layer has a valid license issued by the State of
Connecticut and has filed a satisfactory bond and insuranc policy in ; the
name of the Town of South Windsor:
E g/ ne r g Dept. Date
Permit Fee Paid $ •�� Check y ber \C-.
Connection Charge Receipt No. Dated \cL�
Issued by LLi
j
INSPECTION
Date work started Z, 13 Date. completed
Sufficient notificati nx rece •ve : es No
Special Conditions
.k-
APPROV
42
Z.~93
Inspector Date
SANITARY LATERAL & EXCAVATION PERMIT
t INSPECTION REQUEST
DATE OF REQUEST: ql-/ - 93 TIME:
BY: Mia lId a FOR LOCATION:
DAY INSPEC. NEEDED �'-Z -� TIME: / ��� . A _
TYPE OF INSPECTION:
( SANITARY/LATERAL (PERMIT NO. FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: 9- Z3 TIME: iOp I ; dt, INSP: �� /�
r
CONTRACTOR: WEATHER: (� '
WORK IN PROGRESS: / &�4
/V1 Q
r
AREA OF CONCERN: :+
JG
SPECIAL INSTRUCTIONS: