HomeMy WebLinkAboutDrain Layers Permit 92 Spinners Run TOWN Of SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT NO 6065
Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein to perform the work indicated b to at
rl+rn%� /� at remises owned by C/ y`'t £
whose address is C
At YQ nr and to
Lay House Drain,, Re air House Drain, Lay Main, Other ,
for occupancy or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ),
INDUSTRIAL WASTES ( ) , OR rr
Connection will be made with Nc►S n,
Show sketch of proposed work or, furnish 'two (2) copies of separate drawings.
67
OSHA REQUIREMENTS MUST BE FOLLOWED
SPECIAL CONDITIONS
Desired Starting Date Z-/6--`j3 Es.t-i�-mated Time for Completion
Permit to be issued to C! -h-!�O F1 o 7f_cicic1.1� �{ ( �Csc i S �!5
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 . forth in the permit and the reverse side
thereof. Applicant has received Town Permit Now. and/or
CHD Permit No.
Sigd'' i—A.
Lice ,
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:
I z/is7�:3
njgin ing Dept. Date
Permit Fee Paid $ Z�~.• UU Check�`jNumber
Connection Charge Receipt No. w¢ Dated Z
i
Issued by ,
t 1-
INSPECTION
Date work: started Date completed
Sufficient notification rece e : es No
Special Conditions
APPROVED:
Inspector Date
SANITARY LATERAL & EXCAVATION PERMIT
r
INSPECTION REQUEST
DATE OF REQUEST: 12- ��J� j TIME: l04
BY: FOR LOCATION: Ly7
DAY INSPEC. NEEDED�Z�l(.�1�'j�j TIME: � � �0
TYPE OF INSPECTION:
( SANITARY/LATERAL (PERMIT NO. C���� ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: /�- �6�93 TIME: �� ¢ I N S P
CONTRACTOR: WEATHER:
WORK IN PROGRESS: J.,. 2"
r
AREA OF CONCERN:
SPECIAL INSTRUCTIONS: