HomeMy WebLinkAboutDrain Layers Permit 101 Porter Green TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMITNO 6108
Pursuant to written application, permission is hereby granted to the
Licegsgd Drain Lay r named herein to perform the work indicated belo at
whose address S at p emises owned by
n (� a to
Lay House Drain, Repair Ouse Drain, Lay Main, Other
for / occupancy or use, with „r
Family Units, with acres.
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Type. of Sewage to be connected under this permit : SANITARY SEWAGE ( ,
INDUSTRIAL WASTES ( ) , OR .(
Connection will be made with
Show sketch of proposed work or furnish 'two ( ) copies of separate drawings.
OSHA REQUIREMENTq MUST E FOLLOWED
SPECIAL CONDITIONS .0'/hh Weer AV e
V
Desired Starting Date Q Estimated Time for Completion
Permit to be issued to 3phrl -Rr aamr
the holder of Drain Layer's License No. 'Z491r 3p . Permit will expire thirty
(30) days after date of issuance. 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 _,_?
Li ens r
Dr Layer
The above named Drain Layer has a vali icense issu by the State of
Connecticut and has filed a satisfactory bo d and insurance policy in the
name of the Town of South Windsor:
4 lq4
T
ine ng Dept. Date
Permit Fee Paid $ , �j Checkmber
Connection Charge Receipt No. LAIA54 Dated 4-` -Cl
Issued by
INSPECTION
Date work started -S ¢' Date completed 5 - ¢ -9
Sufficient motif icat' on receive . Z:; Yes No
Special Conditions
APPROVED:
Inspector Date
SANITARY LATERAL & EXCAVATION PERMIT
. / INSPECTION REQUEST
DATE OF REQUEST: 5/3< C/'y TIME: C-�? !Uo prrt
BY: s�m) FOR LOCATION: LA 61 ?4 Fief(�
DAY INSPEC. NEEDED �jl�l�/'y TIME: /rI 0,5
TYPE OF INSPECTION: ��
( SANITARY/LATERAL (PERMIT NO. Gla` ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: TIME: IN P
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CONTRACTOR: 77 WEATHER:
WORK IN PROGRESS:
1
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: