HomeMy WebLinkAboutDrain Layers Permit 152 Rimfield Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
- DRAIN LAYER'S PERMIT N2 6103
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer amep erein to perform the work indicated below at
hose r whose address i f .S at a �jnises owned by � T 601
s S"d` , ' p to
Lay Hoe ,Drain, Repair ouse Drain, Lay Main, Other ,
for i
A!h occupancy or use, with sii'Jq j
Family UnitWq with -114;e acres.
Type of Sewage to be. connected under this permit : SANITARY SEWAGE
INDUSTRIAL WASTES ( ) , OR ( )
Connection will be made with D R .3�` Dian'
Show sketch of proposed work or furnish 'two (2) copies of separate drawings.
SHA REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONS S E O./DUJ
Desired Starting Date Estimated Time for Completion
Permit to be issued to J'o�i� GQUceS'
the holder of Drain Layers License No. Permit will expire thirty
(30) days after date of issuance. The undersi$ned -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
L i c, sed Ain 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:
h4-
E gin ing Dept. Date
Permit Fee Paid Che k umber
Connection Charge Receipt No. L `l3 Dated__ y/9-9y
Issued by
INSPECTION
Date work started `-zV -g Date completed
Sufficient notification receive receive,yes No
Special Conditions
APPROVED:
Inspector Date
s ,
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REOUEST
DATE OF REQUEST: TIME:
BY: /Z.p FOR LOCATION:
DAY INSPEC. NEEDED Zia- 41 TIME:
TYPE OF INSPECTION:
( } SANITARY/LATERAL (PERMIT NO. l� 103 } ( FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: l'/ -2�11- °/y TIME: // INSP:
CONTRACTOR: WEATHER: GGGIZi
WORK IN PROGRESS:
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: