HomeMy WebLinkAboutDrain Layers Permit 170 Strong Road a: TOWN OF SOUTH WINDSOR
DEPARTMENT OF PURLIC WORKS
BUREAU OF POLLUTION CONTROL
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DRAIN LAYER'S PERMIT :. O6 160
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Pursuant to written application, permission is hereby granted to the
Licensed Drain Layer named herein .to perform the work indicated.. be)ow a,t,
t premises owned by -
whose address is G
Lay House Drain, ___Repalr House Drain, Lay Main, 'Other. and Co -
for ey selr-ll occupancy,:,or use, with :
•ls , with ?-.3o7 acre
Type of Sewage to be conne Eed under this perm.i' • pSANITARY SEWAGE ( ) ,
INDUSTRIAL. WASTES ( ) ; OR
Connection will be made with ► U�
S� ow sketch of p,� posed work or f nish 'two (2) cedes `o separate drawings.
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OSHA REQUIREMENTS MUST BE FOLL WEIR ° t
PP 'iAL . CONDITIONS
77
Des3 x ed Starting Date" ted ;Time 7 for . :C mp: etip
X
;ermi:t to be i� ued tP�
t holder of Dr�in e'y%I s Li�ens;� Permit:
w � xre� arty
(30) days eft. : ;date ,o,f �ssua, nce The unders. geed Dra,in. .Lyer t}r aees:"
to all the s . and4 conditions Let forth forth .�Ithe permit and .Lhe
there4►f :� as "r ide
p, eceivi'd Town Pe . No. r w
CHD F'e:rm Riot/6=.j6 ° �
31-1
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L i c ns d D r a jti ,...
T ab;y, !e n coed Fain, L.arYerj h s:j a valid license issued 'b,+y
Conne< icpt! and as;�fled 'a satisfactor ; bond =and inns of
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name of e Town °of South+~i�indsof: U 3
v,.�
, Lng nerin° ?gept. u , V
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Permit Fee Paid' " ,�• ,, cr• n� ". �.`-: Check Nnu�ber
Connection Char
ge Reipt No. -
4s_sued by
Kfa••-ri ice_ re x 4 ..
INSPECTION ,
Date work started ` � ??ateoi �#] ed F < �-
Sufficient notific4'ion �: a 'dive �-�
Special Conditions01
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APPROV
Inspector Date
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SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: --9 D
TIME: �
BY:
FOR LOCATION: D
DAY INSPEC. NEEDED e �- TIME:
TYPE OF INSPECTION:
( ) SANITARY/LATERAL (PERMIT NO. �(7O
( ) FOOTING DRAIN
( K ) EXCAVATION (PERMIT NO. Z O ) ( ) OTHER
q INSPECTION REPORT
DATE: ���6/ TIME: /O; - /2" INSP:
CONTRACTOR:
WEATHER: S a
WORK IN PROGRESS: Qy
AI -If
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AREA OF CONCERN:
SPECIAL INSTRUCTIONS: