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HomeMy WebLinkAboutDrain Layers Permit 4 Rockwell Court 6316 TOWN OF SOUTH WINDSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT DATE: 8 -~ 2� =9 _ A Pursuant to written a plication, rmission is her by�gra t d to the Licensed Drain Layer named herein to Ve- form work at Lot# as indicated below, at ices owned by w e address is and td Cay Mouse Drain epair House Drain , Lay Main , Other for occupancy or yse, with / acres. Type of Sewage to be connected under th/s permit. SANITARY SEWAGE(1, 1NOUSTRIAL WASTES<1, ..OR-0 1 Connection wi//be made with 3 g � 5": AI/ work to be in accordance with Town of South Windsor standards, a//OSHA requirements and the conditions indcated.on the back of this permit. Prapaeed s ►rt_ to �PL �- 9�Est/mated ti comp/erion issued to c� the holder of Drain 's iLicense Ato a. d y. lyr holders of P 1, 7 I uses be issued permit. i The u d Drain Layer hereby agrees to all the to wand dndw¢ eet 0. fot�4 end r v e ereof. Applicant h received To Strut Excavatig Pe lV+ Signed. L/cen Drai ayes ,. {, ' - Y FOR TOWN USE Oft Y _ Permit Fee Paid$ (Check No.) Z.3 Y N Connection Charge $ 0 !Receipt No.) --- Dated Insurance on File (✓I( J Sood on File (V( / This permit is hey Issued to the above named Drain Layw.whq has.a valid license issued by the State of Connecdho and has on fyi e,satisf bortd Premises su ' ct to and insurance in the name of the Town of South Windsor. � 3 k Intortown Ag"eernent O ( k' Record of Sewer Assessment 1 J ( , Issued by Datl . INSPt.CTiO Date Work .-$tarted Date Completed 8 2-4 - mot Comments APPROVED: Inspe or Date SANITARY LATERAL & EXCAVATION PERMIT INSPECTION REQUEST DATE OF REQUEST: Cl S TIME: ©'d Q BY: A FOR LOCATION: Q � DAY INSPEC. NEEDED '2.� "), TIME: p �36 441 TYPE OF INSPECTION: ( ) SANITARY/LATERAL (PERMIT NO. 6 ) ( ) FOOTING DRAIN ( ) EXCAVATION (PERMIT NO. ) ( ) OTHER INSPECTION REPORT DATE: ' Z S �FS TIME: 0 8 INSP: CONTRACTOR: WEATHER.; 0o WORK IN PROGRESS: ZL — 1Z H AREA OF CONCERN: i SPECIAL INSTRUCTIONS: