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HomeMy WebLinkAboutDrain Layers Permit 53 Spinners Run r - TOWN OF SOUTH WINDSOR ` DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYER'S PERMIT N2 6062 J O-.e C 'y 19C13 Pursuant to wr tten application, permission is hereby granted to the L:JAegsed Drain Layer named herein to perform the work indicated below at . M P 4S 11t at premises owned by ( , �cti '�. whose addres is and , Lay House Drain, _Repair House Drain, Lay Main, Other , to for occupancy or use, with Family Units, with acres. Type of Sewage to be connected under this permit : SANITARY SEWAGE ( kl-,'� INDUSTRIAL WASTES ( ) , OR ( ) Connection will be made with Show sketch of proposed work or furnish 'two (2) co es of separate drawings. F 4 J 3 OSHA REQUIREMENTS MUST BE FOLLOWED SPECIAL CONDITION '� F Desired Starting Date ... $ , 14 q_gstimated. Time for Completion U� g Permit to be issued to ' t+ , j`. the holder of Drain Layer's License No. c_>C)C) 4 S2 3. 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. . Signed Z46(/- --414:; Lice ' in Layer The above named Drain Layer has a valid licens/ ssued by the State of Connecticut and has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor: ngineering Dept. Date Permit Fee Paid $ r�.�� •©� Check Number Connection Charge Receipt No. '`-wn/ Dated Issued by INSPECTION Date work started 2 — z2z Date completed Sufficient notification rece ve es No Special Conditions APPROVED• !&4ft�Av Z--"— 9. Inspector Date r SANITARY LATERAL & EXCAVATION PERMIT r ' INSPECTION REQUEST DATE OF REQUEST: Z _9J TIME:- � 00 0 BY: Qx .,1C,A FOR LOCATION: DAY INSPEC. NEEDED Z. "8_9 TIME: -Z/: d O TYPES OF INSPECTION: ( �/ ) SANITARY/LATERAL (PERMIT NO. (OD�'� ) ( } FOOTING DRAIN ( ) EXCAVATION (PERMIT NO. ) ( ) OTHER INSPECTION REPORT DATE: /2,� f3 - �J TIME: .`06 �.� ad INSP: CONTRACTOR: WEATHER: m WORK IN PROGRESS: ,PSI r t AREA OF CONCERN: SPECIAL INSTRUCTIONS: