HomeMy WebLinkAboutDrain Layers Permit 43 Bailey Circle TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No 7827
Con es or DOUBLE * _QPNSTRUCTION LLC
Location '
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Type Work N �1 SAN LAT
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Permit No. 7827 Town of South Windsor, CT
Permit Date 09/28/2004 Drain Layer Permit
Expiration Date 10/28/2004 „
Descrip: LAY HOUSE DRAIN
Applicant J 3 E��aation
Name DOUBLE C CONSTRUCTbIdaLCi OSf43 P}iE � 1LE
Addr. P O BOX 785 45 EV), A5,80tIATES LLC
:
ROCKY HILL fC.7 06
S '4•
Phone No.
MA -
The Drain Layer asszg � t'h 's permit k s «r lid `> ac�3a5 sawed by the �.
state and hereby a�reg �• ' cymditio sit rsth in the
W� e� hriwJ..i of South
attached 'Conditio Y t�ns ' k, 1" s s� � p
Windsor standards, s11OS �/ ecarem tr, an�lh� rxrCyzbhed;&•ePditions.
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Issued By \\ ---- --- —' r"sal s ---- — ---------------
Date Inspected r=:.:.:` ..st? BY : rs��� �.Z
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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: .
Lot
Street No. Street Name ---
Premises owned by
Name of Eirm: coo s Phone: B 3 s l
Address.of Firm:_ 1/f rflnn , /7
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main"------; - .
Lay Laterar for Commercial/Industrial
Building .of acres .
Connection will be made with �C
Existing Water Supply: Public Water-= Well
Proposed Start Date .2? Estimated time for oom letion -
P
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 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 Name:_ Cl of
Licensed Drain Layer
Date: ? 04
:: Standard FormA\PerMItAAPPLICATION FOR DRAIN LAYERS PERMIT.dod-
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL,. FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS L43 ifloAq RaA Lof
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS I SIG TURE /
M x ` A ...rd� DATE
TOWN STATE ZIP INSPECTED BY TOWN
��C> 72 a-L '`" l 0 3 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER