HomeMy WebLinkAboutDrain Layers Permit Wyndemere Court (2) r77
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1` TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT 6128
Pursuant to written application, permission is hereby granted to the
Licensed. Drai Layer named herein to, perform the work indicated below at
t premises o ned by" C
whose address is U ,A:7�0, .f d �� �/� [ and to
Lay House Drain, Ztepair 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 (
Connection will be made with
Show sketch of proposed work or furnish 'two (2) copies of se rate �rawings.
to
n P 6"ti P OF
L - OSHA REQUIRE EN S MU T BE FOLLOWED
` SPECIAL CONDITIONS
Desired Starting Date Estimated Time for Completion ,�f
Permit to be issued to �
the holder of Drain Layers 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 No_ and r
CHD Permit No.
Signed
Licensed Drain Layer
/T"/abov namedj `in` ,a er has a valid license issued b tY y he State of
Con a ticut. n ` �4led a satisfactor b nd and insurance policy in the
'r name " •r-W--To 0 South Windsorr
%t ` -E gin ng Dept. Date
Permit Fee Paid $ rIR06 Chec umber k lHo?O
f
Connection Charge Receipt No. kDatedr,Zd,/'
Issued by Z7
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INSPECTION ----
Date work started 5 ��-� 9 Date completed / --9g-
Sufficient notification re lvea: — Eyes No T—
Special Conditions
APPROVED:
Inspector_ Date
Y
SANITARY LATERAL & EXCAVATION PERMIT
a
INSPECTION REQUEST
DATE OF REQUEST: �Z 7/9 4-- TIME:—
BY: `)- W l Z-e-o y FOR LOCATION: �0 y
DAY INSPEC. NEEDED /3I` �4- TIME: o U►l�
TYPE OF INSPECTION: /
( SANITARY/LATERAL (PERMIT NO. 6! Z"B ) ( ) FOOTING DRAIN
{ ) EXCAVATION (PERMIT NO. ) { �) OTHER
INSPECTION REPORT
DATE: 3 1 TIME• INSP•
CONTRACTOR: WEATHER: 0 a
WORK IN PROGRESS: 4117
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AREA OF CONCERN:
SPECIAL INSTRUCTIONS: