HomeMy WebLinkAboutDrain Layers Permit 124 Ridgefield Drive a ... -'ri* r r- �h : f�.f! ti�..5 � t .4 s•,n.. Y '• - r
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TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 1420 6248
19
Pursuant to writ e{i a ation ermissio p , p n is hereby granted to the
Licensed Drain Lay e am h rein to perform the work indicated below at
o � le\� at premises owned by
whose address is and to
.Lay House Drain, Repair House Drain, Lay Main, Other
for �� �f='/�6d�it�y 47 occupancy or use, with
Family Units , with acres
Type of Sewage to be connected�'under this permit : SANITARY SEWAGE
INDUSTRIAL WASTES ( ) , OR ( )
G Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings .
OSHA REQUIREMENTS MUS BE FOLLOWED
SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion
Permit to be issued to �vro G�GOPqG Adl. FP
the holder of Drain Layer ' s Li n s e N d.
a069'/�7 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
7549/3�.Sr Signed
—Lictnised in Layer
The above named Drain Layer has a valid license issued by the State of
Connecticut and . has filed a satisfactory bond and insurance policy in the
name of the Town _of South Windsor :
624-8 -Qp Engineering Dept . Date
Permit Fee Paid $ zSOZ9 CdJM Check Number
Connection Charge- Receipt No. h%3�3/ Dated ?
Issued by kloel
INSPECTION
Date work started f- Date completed 5-2- 9S
Sufficient notificaFioa rece a :: "des No
Special Conditions r•
- AP ROVED:
Inspector Date
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: -- -g.S TIME:
BY: FOR LOCATION: Gam/ ✓� /Z1y r j= i
DAY INSPEC. NEEDED � ME:
TYPE OF INSPECTION:
( SANITARY/LATERAL (PERMIT NO. FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) { ) OTHER
INSPECTION REPORT
DATE: 3 -ZZ - S TIME: I N S P: �aGa/1L
CONTRACTOR: WEATHER:
ci
WORK IN PROGRESS: d,,4 I
G1:, ,66
Cti0�
r
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: