HomeMy WebLinkAboutDrain Layers Permit 86 Spinners Run TOWN OF SOUTH WINDSOR 1
DEPARTMENT OF PUBLIC wORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT' N
2—_1299
CVJ-4 1995
Pursuant to written application, permission - s hereby, granted to the
Lice sed Drain Layer named herein to perform the work indicated below at
at premises o ned y
whose dd.ress- is ..- 6i/ and to
Lay House Drain, Repair H use Drain, Lay Main, Other ,
for occupancy or use, with < �
Family Units, with acres .
Type of Sewage to be connected under this permit : SANITARY SEWAGE .(t.� �
INDUSTRIAL• WASTES ( ) , OR
Connection will be made with l� 3
Show sketch of proposed work or furnish two (2) ; copies of separate drawings,
OSHA REQUIREMENTS MUST BE FOLLOWED
i SPECIAL CONDITIONS
Desired Starting Date — Es ated 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 the terms and conditions , set foYrth in. the per it the reverse side
thereof . Applicant has received Town Permit No . and/or
CHD Permit No .
Signed JZ
Li 8efi sec Dr a y e r
The above named Drain Layer has a valid icense i sue y the State of
Connecticut and .has filed a satisfactory bond and insurance policy in the
name of the Town of South Windsor :
o f
,�y ' Engineering Dept. ate
Permit FeePaid �Z.
$_1a s�. 3 Chec�C umber z» 9 6
Connection ,Charge Receipt No . 2 5,d0 Dated 5?
Issued by W
INSPECTION
Date work started Date completed 2
Sufficient notification re elves : es _ No
Special Condit ons ' ati
/lL eyu -L
APPROV 727
Inspe-ct r Date
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE REQ STs Z Z" > S TIME: .41
BY. FOR LOCATION:
DAY. INIEC. NEEDED___?- 2, 7- �,5 TIME:��/®
TYPE. OF INSPECTION:
SANITARY`/LATERAL' (PFRMIT`'Na }. _ (. ):. FOOTING,DRAIN.
{ ) EXCAVATION - (PERMIT NO. ) ( } OTHER
y INSPECTTIOW REPORT,
DATES �'7- 7 s TIME: ;6 6 INSP: ee��
r = CONTRACTOk A WEATHt xl_
WORK> IN PROGRESS%..
./J ui�. . .�2•�(��f Q.�.�..� .�°�L�,s(Gfl ��=Gsc�*f1ir.��
ltea-4 . -m Ap
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AREA OF CONCERN: ECoa n � �,� /L AA
ell
SPECIAL INSTRUCTIONS:
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
B1 tUD*4G*DDR ESS OR LOT Ng : L
STREET:
SUBDIVISION:
NH STATION : +
NORTH ARROW INVERT ELEV:
TIE TIE
J ¢
-FT Y
FT
HOUSE LATERAL LATERAL
____ __✓ ____ HOsUSE _
CONNECTION STUB 1 STU:Q__� CO EGTtON-
F.I• A FT
BUILDING INV. ELEV. INV.ELEV. INV. ELEV. INV. ELEV, BUILDING
(IF EXIST.) IF.ExIST.)
r°
TIE TIE
o
v
AM STATION : f
r
INVERT.ELEV:
!1'UAITI
coNTR CTOR (R INTY NAME OF CONTRACTORS SUPERVISOR}(PRINT)
ST DD ESS -, SIGNAT E 7- a6— DATE
TOWN STATE ZIP INSPECTED BY TOWN DATE
TELEPHONE NUMBER
WHITE - TOWN PINK- CONTRACTOR YELLOW CONSULTING ENGINEER/DEVELOPER