HomeMy WebLinkAboutDrain Layers Permit 112 Pheasant Way h_;,-,n -•�.,n...:ar-n. ,s"'•.+s.^: iAnP;'�*.Msr.,s .u�'f.'v," s a_`�,7 #' s-:^+F�". .:. a ^:�, sFr'�", t,.,..
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6422
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
DATE: Z:5'c�
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to
perform work at /%2 :�lem- --.4,Vr wA s/ Lot# as indicated below, qt
premises owned by gl- . whose address is�„3-A �sTav6 �u�,' .rand
to Lay House Drain , Repair Howe Drain , Lay Main , Other , for ��6,;/ ,,;,;4,�
occupancy or use,: with 2 acres.
Type of Sewage to be connected under this permit. SANITARY SEWAGE. ( , INDUSTRIAL WASTES(L
OR{I, Connection will be made with o " h V C_ All
work to be an accordance with Town of South Windsor standards, a//OSHA requirements and the conditions
indicated'on the back of this permit.
Proposed start date � /9/�� Estimated time for cof�p�legon_ s
Permit is to be issued to o.y.¢/al AJ,.?w %1J the holder of Drain Layer's License No.
,SA!V,e y,/ Only holders of P1, P7 & W9 licenses will be issued permit. Permit will expire thirty <3Q1
days,after date of issuance. The undersigned Drain Layer hereby agrees to al/the terms and conditions set
forth in the permit and the reverse side thereof. Applicant has received Town Street Excavation Permit No.
and/or ConnDOT Permit No.
Signed
Licensed Drain Layer
FOR TOWN USE Oft Y
(ihcluc�eC� w� Sa
Permit Fee Paid $ 5 O U (Check No.) q 304 ('vk t'•M k 2t82)
Y N Connection Charge $ EW.C)Q (Receipt No.) Dated —i -
Insurance on File (
e
Bond on File (1-fO 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 file, satisfactory bond
Premises subject to / and insurance in the name of the Town of South Windsor.
Intertown Agreement
Record of Sewer
Assessment O ( 1 Issued by Date
INSPECTION.
Date Mork Started 4.14er Date Completed91��
Comments
APPROVED:
Inspect Date
SANITARY LATERAL. & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: TIME:
BY: FOR LOCATION:�!�' �'`!�'%�-s- yam�✓'
DAY INSPEC . NEEDED E-/!7 TIME:
TYPE OF INSPECTION:
SANITARY/LATERAL (PERMIT NO. Yz 4 ) ( ) FOOTING DRAIN
( EXCAVATION (PERMIT NO. ;Z� c ) ( ) OTHER
INSPECTION REPORT
DATE: TIME: INSP:
CONTRACTOR: �v��i�� ca.�s:,z_ Via. WEATHER:
WORK IN PROGRESS/ �o >� -ram ?-Y�/!�� ��s �✓GG�d
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®rs /✓ / i��H �cv�Cs /r►� �'��/C'�!rG J7
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AREA OF CONCERN: til k C�TI0k) !
SPECIAL INSTRUCTIONS: