HomeMy WebLinkAboutDrain Layers Permit 132 Orchard Hill Dri :.:ir^.. rr:.. pMrry�a�•+"+-s 's77?kR`fu r`Rk"^". W r..
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TOWN OF SOUTH WINDSOR
- DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 1 3 3
1V� / 19, �dtl
Pursuant to written application, permission is hereby granted to the
Licensed Drain La er named herein to perform the work indicated below ,a,t .
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.4 at pr�mi s owned by �
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whose address is 002H A and to
Lay House Drain, /" Repair douse 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;:pr iposed work or furnish 'two (2) copies of separ-Sr'e►�" ra.wings.
(�'rpdc
L�co +Lt.OSHA REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONS ra :
Desired Starting Date g 12 0 } Est mated. Time for Completion -
Permit to be issued. to "
the holder of Drain Layer's License No. . P. Permit wil e7t01t'e- th°'3Yty
(30) "days after date-of issuance. . The unders geed Drain;. Layer -;hjhky a.aroes
to all the terms and conditions. set . for.th,.,in .the permit. and 'the', i4i ,Xse °si-de
thereof". Applicant -has. -received Town Per-hilt No.
CHD Permit No. y ,
Sign
Lice Drain- Layer
The above named Drain Layer has a _:valid lice a isd., byth -ag f
Connecticut and has, filed" a satisfactory bond and insurance .Sb3tyn� r " e;
name of the Town of South'. Windsor
E g n e n;g D"e $fit is
Permit Fee Paid $ 6.�1Q Check umber `
Connection Charge Receipt No. Da-to
Issued by ''�
INSPECTION
Date work started !v- �'�g �` Date completed ( � a ;
Sufficient notifica on rec ve : es No
Special Conditions
APPROVED: 1 /�
; :� Inspector. Date
. SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: 7! 14 TIME: eel
BY: F-1 A V U FOR LOCATION: /,j Z60
DAY INSPEC . NEEDED 61z-C) l 4- TIME: /c
TYPE OF INSPECTION:
( � ) SANITARY/LATERAL (PERMIT NO. / 3V ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: `7�f TIME: 730 INSP:
CONTRACTOR: WEATHER:
WORK IN PROGRESS: �vh ILI f J?--A�� Gd/z:� 11'a--
i Ai=
AREA OF CONCERN:
SPECIAL INSTRUCTIONS:
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