HomeMy WebLinkAboutDrain Layers Permit 35 Bailey Circle TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7851 Contiaetorf`DOU ` '°:G<;;,�ONSTRUCTION LLC
Location 0035 BAILEY CIRCLE ldclreaq mp O $-PX0-:785""4.:5. EVANS RD
Type Work NEW SAN LAT f' 4
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Permit No. 7851 Town of South Windsor, CT
Permit Date 10/28/2004 """ Drain Layer Permit
Expiration Date 11/27/2004
Descrip: LAY HOUSE DRAIN
Applicant Lcra:t`3 on
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Name DOUBLE C CONSTRUCTI.�iN:�<>�� •-..<`�:<:'>t:.``':a: yy�� �.I E ``�I CT)
' " 0Addr. P O BOX 785 4 SHADYR: :p850C1TES LLC
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ROCKY HILL
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The Drain La
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state and hereby agi%e@,s:'-<''toa >1.`"'€:the �°EYRYS 2kx�it cr�t'cst, :t. # _s'et;;;for h in the
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attached Conditions , »>' 1''::gac lt';. 'Y3> 3'} "': `` is dari, ' ':wta'tk Ib�fh of South
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Windsor standards, a13 OSHA x`< uem" :>seaCSi,:; :a_ :<; te"atta :Yeel:,..cnclitions.
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Date Inspected ______ Yipee3"Tay .tom
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: 35
Street No. � � e
Street Name
Premises owned by Ae Q ords
Name of Firm:_
Phone: §� 72 1 1503
Address.of Firm: P 4. &Y ?85
?YPE OF WORK:
Lay House Drainer Repair House Drain
Lay Main
Building .. � , Lay Lateran f_or Commercial/Industrial
acres
Connection will be made with .P V ram. .
Fxistng Water Supply: Public-Water . V Well
Proposed Start Date )0 ,2 R
Estimated time for completion do vALL WORK-TO BE IN ACCORDANCE WITH TQy1/N OF SOUTH WINDSOR STANDARDS AU.OSHA RWREMENTSAND CONDITIONS ATTACHED TO THE PERMIT
Permit-is to be issued.to the holder of Drain .Layer's License No. 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 Naine,- &r),s �►,%��
Licensed Drain Layer
Date:' 10 2% 0q -
Standard Forms\PermitSWPLI.(.ATWN-fm DWN°LAYERS PERMIT.doe _
_ TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: ZQ — O
BUILDING ADDRESS : 4-35 L6J Li
STREET : 6 91W C"rcd
SUBDIVISION: d v l3tc�o
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET (ADDRESS SIGNATURE
v� l � ( Q-- - �..� DATE
TOWN STATE ZIP INSPECTED BY TOWN
�-&o _ -),;-/ / C) DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER