HomeMy WebLinkAboutDrain Layers Permit 20 Podunk Circle _ `xy�,yB •.•rtirao..rurir .'. -<:._s ,;s� :;��' .A '-' .::fj`r'�.r:�' `!r's: '?w�:,l' `S"��'T�sy�?r'." `'.;yi`-_':r;.'.E^'.y
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TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
DATE:
Pursuant to wr/tt application, erqssion is hereby granted to the L/cens d Drain Layer named herein to
perform work at N L i a? of�# as ind/c ed below,,at
prets'owned by whose address is /�/ _ .kd1cJD#2 and
to is-ilhWse Drain � Repair House Drain Lay Main , Other , for
ocaUenr or use, with acres.
7r, k r swage to be connected under this permit.• SANITARY SEWAGE. INDUSTRIAL WASTES 11,
OR•f Connection w/l/be made with PVC Al/
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 siart date Estimated time for com /etion � YS
Permit A, ' '", issued to. ALL the holder of Drain Layer's License No.
Only hotders of P1, P7 & W9 lic nses IA be issued permit. Permit will exvire thirty PSD)
days::aft date o'9issuance: The uhdersigned Drain Layer hereby agrees to all the terms and conditions sot.
M` forth in the permit and the reverse side thereof. Applicant has received Town treat Excavation Permit No ,
.and/or ConnOOT Permit No.
Signed
Licensed in Layer
6 .
E FOR TOWN USLY
Perm,/t Fee Paid$T a� O0 ( h Ck NoJ QQS
Y N Connection Charge $ 00, ldhi,
5 Dated 2 , 0•45
Insurance on Fite N l J
Bond on File (�J This permit is hereb trued to abo4named•Di n Layer"o has a validlicense issued by the`-S40 ofand has�n file,saft*ctory bond
Premises subject to and insurance in the bane of the Town of South'Windsor.
Intertown Agreement
Record of Sewer 9/� �-
Assessment ( J ( 1 Issued by Date !! /
t k
A i. lob
,. . -
INSPECTION
Date Work Started aL a a Date Completed L
Comments
11-04
APPROVED:
nspector Dat
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: 9-2-O , 7. TIME: ;
BY: FOR LOCATION:
DAY INSPEC. NEEDED TIME:
TYPE OF INSPECTION:
( ) SANITARY/LATERAL (PERMIT NO. FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: - TIME: ,? e - 2 `o e INSP:
CONTRACTOR: WEATHER:
WORK IN PROGRESS: 7641-1
R
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: