HomeMy WebLinkAboutDrain Layers Permit 14 Porter Green TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT S203
Pursuant to PwritCehappl 'c. on, permission is hereby granted, to _the
Li erysLd grain Layer ''na d' e e ,tororm the work indicated below a,t.
at 'pr iseg`.oV ed by � �C �
:
whose address is p a, Gh� sand to
Lay House Drai , Repair H se Drain, Lay Main, th; r
for F �': occupancy or use, with 5
Family Units, 4ith y acres. 147
Type of Sewage .to be connect under this permit SANITARY SEWAGE (N '
INDUSTRIAL WASTES ( } , OR
Connection will be made with
Show sketch of proposed work or furnish 'two (2) copies of separate drawing-s.
rf OSHA REQU`IREME SILTS '
SPECIAL CONDITIONS
Desired Starting. Date `Est =attP_ Time for Completion
Permit to be issued to , $ "}
the holder of Drain Layer' s License No. VPC79
,S Yd% 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 e
Li sed in Layer
The above ,named Drain Layer has a v id license issued by.- the State of
Connecticut and has filed a satisfactory bond and insuranc,e. pol.icy in the
name of the Town of South Windsor:
Engineering Dept. Date -
Permit Fee Paid $ ;j V� Check Number
Connection Charge Receipt No. 20 Dated
Issued, by f `
INSPECTION
Date work started Date completed �� ^�
Sufficient notif icai'on race ve : � "yes No
Special Cond ti ns O � �r o
APPROVED:4��6 a e�"Mo
Inspector Date
SANITARY LATERAL & EXCAVATION PERMIT
- INSPECTION REQUEST
DATE OF REQUEST: ��� 3 -9 4- TIME: Z ' O
BY: —nd 5 FOR LOCATION: 4r
DAY INSPEC. NEEDED -3- 4� TIME:-
TYPE OF INSPECTION: A
( SANITARY/LATERAL (PERMIT NO. fp Z Q3 ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: 3 " TIME: 2 ' INSP:
CONTRACTOR: WEATHER: A, °
WORK IN PROGRESS:
Q �
c
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: