HomeMy WebLinkAboutDrain Layers Permit 0209 Avery Street TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7472 Contractor SKIPS SEPTIC
Location 0209 AYE,,Y STREET. '$ Address 27 MUDDY BROOK ROAD
Type Work NEW SAN LAT ELLINGTON CT 06029
o No. (860)875-2332
Date Insp Needed s
Time Insp Needed t3�
Inspected By
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Peri[Itt' ,to. 7472 Town of South Windsor, CT
Permit Date 07/18/2`6b2 Drain Layer Permit
Expiration Date 08/17/2002
Descrip:
Applicant Location
Name SKIPS SEPTIC 412 AVERT STREET
Addr. 27 MUDDY BROOK ROAD . , A ZI A
ELLINGTON CT � s
Phone No. (860)875-2332
i
The Drain Layer a ri as cense issued by the
state and hereby agr ea t nd i s set forth in the
attached 'Conditions' . 1 r a with Town of South
Windsor standards, a1 q e t ached conditions
x.
Issued By .
By Date Inspected
- i
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE,
SOUTH WINDSOR, (7'
FEE $25.00
Location of proposed work: 20 9 4 E2Y Sr Lot #
Street No. Street Name
Premises owned by:
Name of Firm: Qyk Phone: 5' 7 SL 33 ;?-
Address of Firm: ? PZ2) f�
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 12VC-
Existing Water Supply: Public Water Well
Proposed Start Date ? Zy Estimated time for completion ?A3
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 4t k- the holder of Drain
Layer's License No. Zo-79?-.'5— 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. moo Z
Signe Print Name: 7Yfk& RS ej#-Llc£- �P
Licens Drain La er
Date:_
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: lra*5 I u
BUILDING ADDRESS o,oq Avzw-1 ST
STREET
SUBDIVISION:
NORTH ARROW 0
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CONTRACTOR (PRINT) NAME OFQCTRA R' SUPERVISOR (PRINT)
STREET ADD ESS SIGNATURE
DATECI((r\ CT a 67D ,U
TOWN STATE ZIP INSPECTED BY TOWN
_ a 3 l)- DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
' . .
**
(CALL BEFORE YOU DIG - CT) 07/17/2002 14:21 :03
-5G -AH -C4 -CW
-G5 -GV -OT 13-SW SWINDS
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� __________________________________________________________________________
***** ROUTINE *****
TIME. . 14: 19 DATE. . 07/17/2002
REQUEST NO. . . 20022902192
LATITUDE. . 41. 8218631 LONGITUDE. . -72. 5204849
TOWN. . . . . . SOUTH WINDSOR
ADDRESS^ ^ ^ 209 �7r-
STREET. . . . AVERY ST
NEAREST
w�
CROSS STREET. . CARMEN RD
__________________________________________________________________________
TYPE OF WORK. . . . . EXC TO CONNECT TO SANITARY SWR
AREA IS MARKED. . . YES
REMARKS:
WORKING IN THE FRONT OF THE PROP. . . .
__________________________________________________________________________
START DATE. . . . . . 07/22/2002 START TIME. . 07:00
CALLER. . . . . . . . . . LAURIE WALKER
CALL BACK. . . . . . . 8-5
PHONE #. . . . . . . . . 860-875-2332
FAX #. . . . . . . . . . . 860-875-8)428
ALT. PHONE #. . . .
EMAIL ADDRESS. . .
CONTRACTOR. . . . . . SKIP SEPTIC SERVICE
ADDRESS. . . . . . . . . 27 MUDDY BROOK RD
CITY. . . . . . . . . . . . ELLINGTON
STATE. . . . . . . . . . . CT
ZIP. . . . . . . . . . . . . 06029
__________________________________________________________________________
EXCAVATOR DOING WORK. . SAME
ISSUED TO: DATE: TIME: BY.-
DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY:
CALL BACK: 1 ) DATE: TIME: BY: 2) DATE: TIME: BY:
PERSON CONTACTED: PERSON CONTACTED: