HomeMy WebLinkAboutDrain Layers Permit 685 Nevers Road ,....rnrP-'w,:'�.,'.�rk'av'S'"�h#�r�';jsltFl•� .f. , �.<.mr'xF' � "9c�i?,�'t`iyty,�,.•'� .,�,... -•;�. .yr.� -rz.a%�.�srk":>"ti4'''�'--'•�'4t,�.. �::a - ,
TOWN OF SOUTH WINDSOR
` DEPARTMENT OF PUBLIC WORKS
! BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT �! 6
� ,-19
Pursuant to written application, permission is hereby granted to the
Li en rsed Drain Lay amed herein to per.form' the work indicated below at
--5- Al0—IM t at premises owned b
whose address is and to
Lay House Drain, Repair House Drain, Lay Main, Other. ,
for occupancy or use, with
• Family Units , with acres.
'i
Type of Sewage to be connected under this permit : SANITARY SEWAGE
INDUSTRIAL WASTES ( }, OR ( )
Connection will be made with
Show sketgfiTolf �riposed work or furnish . ws 6) c�Op`Pes of sepl Ww11ngs.
A.4
OSHA REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion . •,
r Permit to be issued to
the holder of Drain. Layer ' s Like a No. ZOS Permit will expire thirty
(30) days after date of issuancer:., 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
cen ed Drain er
The above named Drain Layer has a valid license issued by . the. State of
-. Connecticut and has filed a satisfactory bond and insurance policy in the
name of the Town of South Windsor
Engineering Dept. Date
Permit Fee Paid Check Number
Connection Charge Receipt No. _,r�' � Dated
Issued by _ L"160
.INSPECTION q� F
Date work started Date completed d
Sufficient notification recelvediT—'—'-Yes No '
Special Conditions_
APPROVED• ¢`� S
Inspector Date
r
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: v` �� TIME:
BY: f/f �'S //�-l�� FOR LOCATION:
DAY INSPEC . NEEDED G��;�� -p� U/�f TIME:
TYPE OF INSPECTION:
O SANITARY/LATERAL (PERMIT NO. FOOTING DRAIN
{ ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: 03 TIME: J ' �'� . �'� ��z INSP:
CONTRACTOR: ' '//'. ,:'�L• WEATHER
WORK IN PROGRESS : (� .
C
/ / J
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: