HomeMy WebLinkAboutDrain Layers Permit 37 Ridgefield Drive (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORM
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT .6238
ri Z/F , 19
Pursuant to written appl*ct on-, permission is hereby' ranted to
g the
Licensed Drain Layer named herein to perform the work indicated below at
o_ % -at premise owned by
whose address is ;fl and to
Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use , with
Family Units , with acres . --'
Type of Sewage to be connected under this permit : SANITARY SEWAGE
INDUSTRIAL WASTES ( ) , ' OR (
Connection will be made with
f
Show sketch- of proposed work or furnish two (2) copies of separate drawings .
OSHA REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONS
Desired Starting Date d Estimated Time for. Completion
Permit to be issued to oeq ear �oY
the holder of Drain Layer ' s ' License o . /7. Fermi 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
_;C.H D. ._P er m_i,t-_.N.o.,.-: ..S' :._. . .. -
Signed
Lice sed Dr 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 :
Engineering Dept . Date
Permit Fee Paid $- 7�S- r Check Number t1.?,3_4,
Connection Charge Receipt No. V J Z11 Dated `573
Issued by J�
INSPECTION
Date work started ate completed
Sufficient notificar'lon`recei'vea : yes No
Special Conditions
APPROVED:
Znspe Date
SANITARY LATERAL & EXCAVATION PERMIT
®„g�INSPECTION REQUEST
E OF REQUEST: T TIME: pO /
Y: G t o /�-(�/% FOR LOCATION: !ti0
DAY INSPEC. NEEDED TIME: G!�//.[� G-/�Yi!✓
TYPE OF INSPECTION:
( � ) SANITARY/LATERAL (PERMIT NO. FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) { ) OTHER
INSPECTION REPORT
DATE: 3® - 2E TIME: ' d o - Z :0 v INSP:
CONTRACTOR: r - WEATHER: o o
WORK IN PROGRESS:
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: