HomeMy WebLinkAboutDrain Layers Permit 70 Robert Drive i
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 6280
19
Pursuant to written application, permission is hereby .grantet to the
Licensgd Drpain Layer na ed herein to perform the work in_�sated below at
at premises owned by 4A F'S _8 I =.61,p�
whose address is vM and to
Lay House Drain, Repair House Drain, Lay Main, Other ,
for �RM�_l<<J 1-4(>t. occupancy or use, with
Family Units , with /c1 acres .
Type of Sewage to beconnected under this permit : SANITARY SEWAGE
INDUSTRIAL WASTES ( ) , OR
Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings .
0t'4
OSHA REQUIREMENTS U T BE F L OWED
SPECIAL CONDITIONSAga
j ,
Desired Starting Date Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer 's License No . Permit will expire thirty
( 30) days after date of issuance. The undersigned Drain Layer hereby agrees
to all th-e terms and conditions set forth in the permit and th reverse side
thereof . Appli has rec ad Town Permit No . rid/or
C H D_-P--e-r m4_t;__-.N4D..-
Signed
icensed ;�d
i er
The above: named Drain Layer has a valid icense -ssu y the State of
Connecticut and . has filed a satisfactory bond and insurance policy in the
name of the Town of South Windsor _
Engifieering Dept. Date
Permit Fee Paid $ a5On Check Number 35%
Connection Charge Receipt No G280 -Dated 5/1/'9
Issued byw
INSPECTION
Date work started t< -_16 Date completed 57
Sufficient notificaulon receives : des No
Special Condition
AZI
APPROVED: �'� s
Inspector Date
SANITARY.LATERAL &_EXCAVATION PERMIT
6,-/6'� b/INSPECTION REQUEST
DATE �OF REQUEST: TIME: `F2 •� vt�
BY: I��� �!/� /S�/Gy FOR LOCATION: �70 �L�
'.'DAY INSPEC.. NEEDED _ TIME:co
TYPE 0E—- INSPECTION: `/G
t ( ) S'ANTTARY/LATERAT E'gERMET`NO Z f9 } ( ; ), FOCT.ING DRAM.
t ( ) EXCAVATZQN. (PERMIT 'NO: ) ( } OTHER
INSPE TIONI'REPORT:,..
i DATE: fCJ`� �6 / TIME: //,`D d - /,'3o INSP:
CONTRACTOR'r
WORK IN- PROGRESS:. AC, ,�2ccJ��TY ,Xll� flea
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: