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HomeMy WebLinkAboutDrain Layers Permit 0200 Avery Street TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No Contractor LEO BOND, INC. Location TREET-4 Address 1071 ELLINGTON ROAD Type Work ,`'Nw SOUTH WINDSOR CT 06074 e No. (860)528-0661 Date Insp Needed 6 / 4neD Time Insp Needed A I Inspected By Work in Progress 1/ G 5 � �-o 6". ,�c�l ei pry ap(Ad UA O&�/ tl , MNL Date (0Z P%rrAi No. 7.47 7 Town of South Windsor, CT Permit Date 07/31/2002 Drain Layer Permit Expiration Date 08/30/2002 , Descrip; USER FEE PAIb-CK#1140 Applicant Location Name LEO BOND, INC, 0 0 AVERY STREET Addr. 1071 ELLINGTON ROAD T LL BEATRICE M SOUTH WINDSOR C Phone No. (860)528-066 The Drain Layer s i has icense issued by the state and hereby ag 1 t and t, ns set forth in the attached 'Conditions' ° n e with Town of South Windsor standards, a e ached conditions. Issued By N Date Inspected Pa7p By r4 -74-n 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: 7-6D Lot # Street No. Street Name Premises owned by: 22dgA M"TI. Name of Firm: /IFiY icy Conl5r- Phone: 074--1096 Address of Firm: ZWrl- V- A6 62wynl3i CT 06e37 TYPE OF WORK: Lay House Drain Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with Existing Water Supply: Public Water Well Proposed Start Date 3) 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 _I- EV he holder of Drain Layer's License No. P 00P?g '6 . Only holders 901, r P7 licenses will be issued a permit. PERMIT WILL EXPIRE THIRTY (30) YS 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. ZOd Z13©D p S6 Z Signed: Print Name: Licensed Drain Layer Date: �y` -` 7 Jt06j__ Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS a160 �v � STREET t © SUBDIVISION: T� NORTH ARROW I -ilk . ) A ; ' { i , { I t i 1 3 b t y t • 1 V I 1 Y Y E t I ; , . t C r i _. ._ ____ 1 � i } : �( 1E�7'e4 GoSl, KaLet� CONTRACTOR (PRINT) NAME OF CONTRACTORS SUPERVISOR (PRINT) ;?-V� A KT �,� &� STREET ADDRESS SIGNATURE Cou)m 7,:�l/ C/T DATE c TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER