HomeMy WebLinkAboutDrain Layers Permit 25 Bailey Circle TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 7894 Contxalet*Sr Y&«C__CONSTRUCTION LLC
Location 0025 BAILEY CIRCLE ,,9Tdre ? P c 7`85'>.,.;45 EVANS RD
Type Work NEW SAN LAT E : ,.z Y -A CT`°Q,6067
Date Insp Needed "Das •' ,�:#,. f
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Time Insp Needed
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Permit No. 7894 Town of South Windsor, CT
Permit Date 03/30/2005 .-' xh Drain Layer Permit I
Expiration Date 04/29/2005
Descrip: CASH FOR PERMIT FEES
Applicantje
Name DOUBLE C CONSTRUCTS' b I.7sC,
... .:,.>yvirr�'�:.:•> Ayrrfi��t'fi�.B ng", C_Y...R6,S..E
Addr. P O BOX 785 45 AVAIN Sd" er SHADYR ATES LLC
ROCKY HILL
Phone No.
s , r /
The Drain Layer' assin�et zi' y �� + �id '1�ene: issued by the
state and hereby adrreg �{ t�i` brei�tf� a d�'��€ i ` het' forth in the
attached I C o n d i t i o n
,., kx �Yrraye? ili'`4cwn of South
Windsor standards, a' 1 OSHA; '4q`tX'a> E7NY's c ✓Ckr "at$ hd c editions.
Issued B
,
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Date Inspected --------------------- 3�ars:��Cia.: y ---
70Y
s= 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: j e L,(C-Ile Lot # 3
Street No. Street Name
Premises owned by:
Name of Firm-_DL)b I -- C 06,.f 1 Phone:S�10- 7v1, 1" /s-o 3
Address.of firm:�/ - qf a KT2cC Gc.
TYPE OF WORK:
Lay House Drain__k _; Repair House Drain
Lay Main ; Lay Lateraf for Commercial/Industrial
Building of acres
Connection will be made with _6
Existing Water Supply: Public Water_ Well
Proposed Start Date3_3G-5Estimated time for completion r,?. htS
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��G.r1 C-0 the holder of Drain
Layer's License No. dD 6 sG CP 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.
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Signed: _ Print Name: �_�
Licensed Drain Layer "
Date: — .5 G --G
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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