HomeMy WebLinkAboutDrain Layers Permit 20 Bailey Circle r
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7802 Contxaactor DOUB ff""E1,.CONSTRUCTION LLC
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Location JA re9*4-.k 0 8'pX 7<85 45 EVANS RD
Type Work NEW SAN LAT
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Date
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Time Insp Needed -- gmIr � k
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Permit No. 7802 Permit Date 08/19/2004 Town of South Windsor, CT
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Drain Layer Permit
Expiration Date 09/18/2004 h
Descrip:
Applicant
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Name DOUBLE C CONSTRUCQd L
:. 0070 AT ES" RQLE
Addr. P O BOX 785 45 EVMN-S I y
ry x v $RAgyo CkIATES LLC
ROCKY HILL a :,w. .. f,.; .. ,::..<•..<`
Phone No.
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The Drain Layer...--a s perM.a.�t, a§AC 'f alid ac xis fis ted by the
state and hereby agreafa3'` _ tx<yu8 £��htiditi¢as e't.,forh in the
attached 'Condit v...;d11d r sfz3 b �sttratky Town of South
Windsor standards al fSHA
£ etirsm t aot
eacl�ed. �r3itions.
Issued B
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Date Inspected
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APPLICATION FOR DRAIN LAYER PERMIT J40—
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: *ZO x ` 1 v C k r-C Lot #
Street No. Street Name
Premises owned by: S kc.J`� coo ,A s 5
Name of Firm: dui1c C_ Coy-c4 7a✓ -� 3
Phone:
Address.of Firm: << S va-.L s
TYPE OF WORK:
Lay House Drain X Repair House Drain
Lay Main ; Lay Lateraf for Commercial/Industrial
Building of acres
Connection will be made With PO C.�
Existing Water Supply: Public Water__ Well
Proposed Start Date - t - 09stimated time for completion l dc"
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WIN'DSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to eccv _ C<<k�" f the holder of Drain
Layer's License No. jG R- S G 6 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: io�ce� �o t
Licensed Drain Layer
Date: R--
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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