HomeMy WebLinkAboutDrain Layers Permit 0309 Avery Street TOWN OF SOUTH WINDSOR INSPECTION REPORT
Pirmit-No. 7363 Contractor SKIPS SEPTIC
Location u"0309''-AVERY ,RtR1ET Address 27 MUDDY BROOK ROAD
Type Work NEW SAN LAT ELLINGTON CT 06029
Phone No. (860)875-2332
Date Insp Needed 01 all .rt
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Permit No. 7363 Town of South Windsor, ,CT
Per.mip. Date 12/03/2001 Drain Layer Permit j
Exoi-Ca`Ci on Date 01/02/2002 41,
Descrip:
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Applicant Location
Name SKIPS SEPTIC Addr. 0309 AVERY STREET
Addr. `.27 MUDDY BROOK ROAD Owner FLORES OLGA I
ELLINGTON CT 060
Phone No. (860 )875-2332 !
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The Drain Layer as$- gnedt this pt this < valid lf,,cense issued by the
state and hereby agrees' t� ,a ? =tl��`1s `ms:.and ' cc�n Jt�i"c?rns set forth in the �
attached 'Conditions' ; {.A1 wprk 'ha i i>n aouC?rdat�ce with Town of South j
Windsor standards, all OtA r q t ^etlntas and attached conditions.
Issued By ` =�NAs
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Date inspected z sr a-/ Inspected By
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work: "30? &E lc y Sf— Lot #
Street No. Street Name
Premises owned by: C�c .S k1110 6J �-C 7-0 A/
Name of Firm: Sk rp5 s !F117T1C Phone: a? 3 Z
Address of Firm: 'Z7 M c4J)➢Y 01?oU1.-- 9' 'FLL IN��
TYPE OF WORK:
Lay House Drain X ; Repair House Drain
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with �p UC cSML
Existing Water Supply: Public Water 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
Permit is to be issued to —13'N" Ilu-I ',L ke n-- the holder of Drain
Layer's License No. 2_o'7 1 ys . Only holders of P1 or P7 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. / 9'0 2 7? ,
Sign : ' Print Name: —77MO^ G�►d -lC�� �,�
Licensed Drain La er
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc.
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: a 1l �bl
BUILDING ADDRESS : 3(��j ALA `1 5_1 RE ENFn
STREET : DEC 14 2001
SOUTH WINDSOR
- ENGINEERING DEPT.
+ SUBDIVISION: \
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRA TOR'S SUPERVISOR (PRINT)
a1 ku9,`7 6�ao�-_ Q0
STREET ADDRESS SIGNATURE
fl-<QNGT®ti C7' . cl DATE
TOWN // STATE ZIP INSPECTED BY TOWN
966 —66q` b DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER