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HomeMy WebLinkAboutDrain Layers Permit Lot 39 Rockwell Cour TOWN OF SOUTH WI N DSOR DEPARTMENT OF PUBLIC WORKS A BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT 6054 Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named }ere to perform the work indicated below at Wfi��f �l� ��/ ��o at .�'r�mises owns b se address is t-�e byLay -for ` �House D;/ in, Repair ouse Drain, Lay Main. V and to Y 0 t he r_,f�� occupancy or use, with Family Units, with k4el acres. ' Type of Sewage to be connected under .this permit: SANITARY SEWAGE INDUSTRIAL WASTES ( *)'�, OR ( :) , Connection will be made with S D JS S�pcCJo/' , b� Show sketch of proposea work or furnish 'two (2) copies of separate drawings SPECIAL CONDITIONS OSHA REQUIREMENTS MUSTo E POLLO ED Desired StartingDate Ll--30=23 Estimated Time for Completion ,,, � Permit to be issued toOhr� the holder of Drain Layer's, License No. 2©_ dg,30 Per 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. CHD Permit No. and/or Signed Licens rain yer ,The above named Drain Layer has a val4d license issued b the St Connecticut and has filed a satisfactory bond and insurance o ate of name of the Town of South Windsor: policy in the Engineering/7Dept. Date Permit Fee Paid $` � Check Number 0 7 Connection Charge Receipt No. 3 5 — ' -� !-�0 Dated Issued by INSPECTION Date work started /1-= 3d � q Date completed_ Sufficient notifica on ece ve '-'—ye8 Special Conditions '— No APPROVD: i�:',Iii:��Jjlr 30` j Inspect'or Date SANITARY LATERAL & EXCAVATION PERMIT INSPECTION REQUEST DATE OF REQUEST: \������ TIME:_ BY: \\��.(Y`� try FOR LOCATION: Ipt ag DAY INSPEC. NEEDED ���' j\�� TIME:_ TYPE OF INSPECTION: ( ✓1 SANITARY/LATERAL (PERMIT NO. FOOTING DRAIN ( ) EXCAVATION (PERMIT NO. ) ( } OTHER INSPECTION REPORT DATE:_ /` O TIME• /d; 60 -- INSP ?_/ Z CONTRACTOR: WEATHER• °4" WORK IN PROGRESS: U AREA OF CONCERN: SPECIAL INSTRUCTIONS: