HomeMy WebLinkAboutDrain Layers Permit 2 Honeysuckle Lane s_
TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
r BUREAU OF POLLUTION CONTROL p
DRAIN LAYER'S PERMIT 5789
t"i 0
.i!-,,; e U , , 1901
Pursuant to written application, permission is hereby granted to the ,
:Licensed Dr.a }� Layer named herein to perform the work indicated below at
G� 2r (o rJ at premises owned by Z ,c O S
whose address is �� E S�- c;W -+J s4 a,-g and to
Lay Rouse Drain, ,_Repair House Drain, Lay Main, Other ,
for ( 2 P-q P V�. vy✓ occupancy or use, with ( /i..,
. :Family Units , with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE (Q ,
INDUSTRIAL WASTES (' ) , OR `(
Connection will be made with
Show sketch of proposed work or furnish two (-2) copies of separate drawings.'
ev
SPECIAL CONDITIONS
Desired Starting Date - Estimated Time for Completion
Permit to be issued to
the holder of Drain Layer' s License No. 20 25h_. Permit 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
CHD Permit No.
---g n e
Licensed Drain 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 $ Check Number
Connection Charge Receipt No. Dated
Issued by
INSPECTION
Date work started ate completed ''3�-' Z.,�
Sufficient notification rece ve : _ es No
Special Conditions
APPROVED, 3
Inspect r Date
l
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS OR LOT N2 : Z
STREET: )-i0V4EV 15L' CAE LANG
SUBDIVISION: tPC -l-i{�KG�O ICG
bH STATION : 1 3 +3�
NORTH ARROW FLATERAL
: i�•3y.
U.
to ,
V)•'I
00
TIE TIE
-FT -FT.
HOUSE __ LATERAL _ HOUSE
CONNECTION STUB STUB CONNECTION
FT. It FT.
BUILDING INV. ELEV. INV.ELEV. INV. ELEV. INV. ELEV.
(1F EXIST.) U. BUILDING
(IF EXIST.)
10 Fooctrlc, 1r1U.@ HCuSc
TIE TIE
K
P� ? 5TA ►t*10 • NH STATION :-I t + 60
I N.od'T dui
w � Fa,T„ir, 1n0+ �1 INVERT ELEV: 11 C�.2r
-POU PER CIC*157• Avi EWL)A rl W
� � �o CcAE6 HhANt-K — 69M 81,Iiagf_5
CONTRACTOR (PRINT) NAM OF CONTRA TORS SUPERVISOR (PRINT)
G-I --At F rA�Ae_ C4RcL�e 1-76 r_APDuoF_
>?D.
STREET ADDRESS S16-NATUkg DATE
5. IN> r -�, �Z�R�) CT.
TOWN STATE ZIP INSPECTED BY TOWN DATE
( z,�'5 ) 5z8- 73$3 ) 859-2561
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW -CONSULTING ENGINEER/DEVELOPER