HomeMy WebLinkAboutDrain Layers Permit 45 Summit Drive N^ 6346
. . TOWN SOUTii WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAINLAYER'S PERMIT
DATE:
Pumuapt to written epMka , permission is herabYWsrner/Woke[homed Oreln layernsmedhereenW
per/orvn work,r4i, Lr Ae1pe . Lot# /0m * te�(bdoW, m
promise owned by whose sdMessis /7YY ECLbiU /!D and
tp CaY House Drain Repair House Grain _ lay Maln � Otlrer� for
occupancy or use, with acres.
Type of Sewage to be connactad mMer thh pmmR: �SAH/TARYSEWAMXL IHOUSTRIAL W��A������++^^/A
OR l J Connecdon Ube made with �. Ak
wwk m as in acwNanro with Tom of south Whdadr smaaob%, ad OSHA ipvbements ait dre cmMidmm
' mdicaredan Me beik o1 Mh perm/[.
Propcaed start abte � � EannNme� t�ed rane Rv wmpleden Z ��
Permh Is re be hsued to ✓0//r[pme LM/n G; /✓C, the kidder of GMaln[aYe/'s Lkww N
207707 . .Only hahm; of PI; P1 S WS Ecenaes wrfb as owed perm/; eermo wdr ermre Mery /SOI:
dava M er dead et onef aa. me urMemigrwd Orein a 'eby eAeui oo ed.Ma terms vv a phhrm em
Mr"M��In Me Pamir co Merororse aM" e M f r e rxdved Town Sbex fi vadon Permit No.
_La a�Corm00TPemdt No. �
p, R/pnW
® /weed 'eh Leyar
FORTOWHUSEOM.Y Aq.�,,AA ...11
Permitt Fee Pdd4 � i !Check Ro.l ` f44
Y �11 Connection Charge d /Op - Do hTvoeptfb.l SC0 abo' /o
Insurance on Fh lufl 1
Rondon Fee !� ) ThopemMv MrebYisevadM the adonnrmd OrW[ayw wbo Mss wMd
Sconsehm odby the State afComwodwrtaM hsa on We,sadsbamry brief
Remises sukkot w andmsmance h Me name of Me Town ofS YYhmbm.
mtmmwn AProemant III
Record of Sewm
Assessment I I e / owedbY Om
INSPECTION
Date work Started /� '�°0�25� Date completed !o ' e8 'S�
commence
9'�i7
xnsaecton pace
rSANITARY LATERAL& EXCAVATION PERMIT _
- INSPECTION REQUEST
OATE: OF FEQUEST: / N 5 TIME: ��7
. BY: -I2 $ LAY �� 1 FOR LOCATION: �✓�� l� I : [ �7�
DAY INSPEC. NEEDED /6 �/8 ' 9S� TINE: P�'h
! TYPE OF INSPECTION:
( � ) SANITART/DHTERAL (FERM vw. FOOTING DRAIN
( ) EXCAVATION . (PERMIT NOl ) . ( ) OTEER'
INSPEOTION:REPORT
DATE: R< �� la ' g5 TIMB: /ram INSP:
x CONTPACTOR: /y yL/YYI- C�i+�Si W TSNN:
WORE IN. PROGRESS:
�p4cS Gc+iy �i'Y - No LL�c 4z� S�6/Y/
AREA OF CONCERN:
3SPECIAE INSTRUCTIONS: