HomeMy WebLinkAboutDrain Layers Permit 165 Abbe Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7640 Contra-c`tor MID 'STA`Z. SITE DEV.
Location 0165 ABBE ROAD Zi[dres;s.; ''::>i P.O,:;> Q f:: 654
::..
Type Work NEW SAN LATANTON 'CT.. D6019.;;.,
Phone .No (8��)693 6$99 ,>_
Date Insp Needed bate 1n:
-----------— - ---
Time Insp Needed
Inspected By
Work in Progress3C "�' _�
:
Permit No. 7640 Town of South Windsor, CT
Permit Date 06/16/2003 Drain Layer Permit
Expiration Date 07/16/2003
Descrip: AHERN SUED. LOT2
i
Applicant " Location
Name MID STATE SITE DEV :: iddr 0165 AB$`E
Addr. P.O. BOX 654 Owner AH ARN FRANTf E TkUSTEE
CANTON
Phone No. (860)693-6899
The Drain Layer assig ned this permit has a valid license issued by the
state and hereby agree a<, to all the tertnt Oh in the
attached 'Conditions' All wQik shall be-An aec+ rdan 'e wx hrTowri of South
Windsor standards, ail >[}SHA requsre:m�ensx amd the attshed conci'itions.
t
Issued By — T1t3e ' err
Y te
--Date Inspected -----____-- — Inspecd By T�`
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: Lot #
Street No. Street Name
Premises owned by:
Name of Firm: lyii✓���7�e G� ,�� ,,,,r Phone: .S�
Address.of Firm: �� Ali fn�e i rr G d�
2
TYPE OF WORK:
Lay House Drain_�.JZ; Repair House Drain
La Main '
4 Y ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water i/�. well
Proposed Start Date Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
/� r
Permit is to be issued to �y �l/ /�iri'}'i the holder of D
Layer's License No. ZFD 9� rain
� . Only holders of P-1, P-7 or W-9 licenses
will be issued a permit. 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 attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No.
Signed: Print Name: / ��"� �vY✓�
-icensed Drain Layer
Date: Z ��
Standard FormsWermitAAPPLICATION FOR DRAIN LAYERS PERMIT.doc
1
TOWN: OF -SOUTH WINDSOR
`SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION.
BUILDING ADDRESS 16-9 AMI
STREET
SUBDIVISION:
NORTH ARROW
s
• V
I
t
�1 ...._
I ! IJ
1 I
f t
' f
�.`r t i j S lei X C�i✓�ia.�. �U 'Z9 h A
CONTRACTOR (PRINT) NAME OF CONT R'S SUPERVISOR`(PRINT)
ST :ADDRESS 1
D 1/ •t/ C,l 3 '^�� .y� ��/®DATE
TOWN STATE ZIP INSPECTED BY TOWN
/s-3 DATE
TELEPHONE NUMBER'
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER