HomeMy WebLinkAboutDrain Layers Permit 65 Troy Road TOWN OF SOUTH WINDSOR
DEPART21&'T OF PUBLIC WORSE
BUREAU OF POLLUTION ONNTROL
Dun LAYERTS PESHI R?? 6178
19
Pursuant i t written application,io permission the w here g[ C d to the
Lice/rya ➢ 1 eyer d herein t perform the k incat d_ 6 lov Jt
a at premise d by J �JV�AQC
M address 1 / � .Q� ov and to
L y .Hmuee Drain.,—Rep House D in. Gay Main( . OL e
for 1 ') C � 14 occupancy or use , with
Family Units , '1 ham__' acres.
Type '. f Sewage Co b netted under this permit : SANITARY SEWAGE•( /! ,
INDUSTRIAL WASTES ( ) . OR O '
Connection will be made withrile,
Show sketch of proposed work or furnish two (2) copies of separate drawings.
3't1UST BE FOLLOWED
SPECIAL CONDITIONS
Desired Starting Date Est i//m��ated Time for Completion
Permit to be issued [ �VEa/.CAA/STStY.fynn�
the holder of Drain Layer ' s License No. ap'lSSL Permit will expire thirty
(30) days after date of issuance. The uncle re Sgnetl Drain Layer M1e re by agrees
to all the terms .and conditions set forth in the permit and the r aide
thereof. Appli has received Tow Permit No . And/or
reverse
GND Per N q�/12a8 /Z
Signed
n Layer
The abovenamed Drain Layer has valid licenses ias re by the State of
',Connecticut and has filed a satisfacto[ bo d . and insurance policy in the
1 of the T f South Windsor:
Z q
Sine g Dept . Da
it Fee Paid B ZS-.00 Cher umber I
action Charge Receipt NO. Pated !6 ?
Issued by
I^N pA
Ik started /"7/� —` Date completed
it tifica a ev y V y N
%onditions
'\ APPROVED : t' _ 4b—
➢ate
SANITARY LATERAL & EXCAVATION PERMIT
INSPECTION REQUEST
DATE OF REQUEST: q - o/ - 4N TIME: • PCaC
BY: FOR LOCATION:
DAY INSPEC. NEEDED FA/ - J-Ocyy TIME• /,/L L 1,2V '
TYPE OF INSPECTION:
- ( ), SANITARY/LATERAL (PERMIT NO. / / ) ( ) FOOTING DRAIN
( ) EXCAVATION (PERMIT NO. ) ( ) OTHER
INSPECTION REPORT
DATE: �z /yTIME: ./ /YI INSP c
CONTRACTOR: S.vdYn ,pLg-rn- (a�()E}IS4WEATHER' S UA V� L
WORE(�N PROGRESS:_
AREA OF CONCERN
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IIPECIAL INSTRUCTIONS:
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