HomeMy WebLinkAboutDrain Layers Permit 113 Overlook Road AAt TOWN OF SOUTH WINDSOR INSPECTION REPORT
Pi6lrmi it No. 6466
Location 0113 OVERLOOK ROAD Contractor PELTON EXCAVATING
Type Work NEW SAN LAT Address 1 ORCHARD LANE
1
/7 WINDSOR CT 06095�7 � ►? +ot1c' No. (860)688-5416
Date Insp Needed
Time Insp Needed
_� Time In
Inspected By
Work in Progress A0-
/.2 - _S"4 d'.:°C.r,r, l.C✓,pia^ �
Date
. 6466
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT c�p
DATE: I /l1 <
Pursuant to written ap fication, permission s hereby granted to the Licensed Drain Layer named herein to
perform work at I d Uc"7 WOK_ Lot# '"'""'as indicated below, at
premises owned by C L C. AJ whose address is and
to Lay House Drain , Repair House Drain , Lay Main , Other for
occupancy or use, with. acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE t , /NDUSTR/AL VA
STES(l,
OR f 1 Connection will be made with (o l r G M
work to be in accordance with Town of South Windsor standards, all OSHA requirements and the conditions
indicated.on the back of this permit.
Proposed start date A& 141 /99b Estimated time for completion
Permit is to be issued to LOtiJ �ZTz�ti/��Z TZ3�V older of Drain Layer's License No.
Z09 Only holders of P1,J!7A W9 licenses will be issued permit. Permit wfl%expire Mi/rtv (30)
days after date of issuance. The undersigned Drain Layer hereb grass to al/the terms and condltions set
forth in the permit and the reverse side thereof. Applicant has a eive Excavation Permit No.
and/or ConnDOT Permit No. ---
S/gned
Ucen ed Drain Layer
FOR TOWN USE Oft Y
Permit Fee Paid$ (Check No.)
Y Connection Charge $ 690 D"'" (Receipt No.) __Pat&d_ELVfkL
Insurance on Filel
Bond on File This permit is hereby issued to the above named Drain Layer who has a valid
license issued by the State of Connecticut and has on f7i , satisfactory bond
Premises subject to and insurance in the name of the Town of South Windsor.
lntertown Agreement { J M011
Record.of Sewer
Assessment ( I ( 1 Issued by AK Date l
INSPECTION
Date Work Started Date Completed �zo�
Comments
APPROVED:
Inspee or Date