HomeMy WebLinkAboutDrain Layers Permit 63 Bailey Circle I
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. Contrf�ta� 5' 3�if$T;'E-c- CONSTRUCTION LLC
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Type Work NEW SAW'UT",
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Date Insp Needed Dater k�
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Inspected By
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Permit No. 7803 Town of South Windsor, CT
E Permit Date 08/19/2004 Drain Layer Permit A
Expiration Date 09/18/2004
D e s c r ip:
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Applicant 4,. <` ''' Location
Name DOUBLE C CONSTRUCTTRiV � Lys �' .00�3 $A'TLESf C1--9'CLE
Addr. P O BOX 785 45 EAI TI SHF� BR6iK ASSOCIATES LLC
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ROCKY HILL CTr<06AQ67a' � K "£
Phone No.The Drain Layer tl�s pertpzt a� ssalidxise issued by the
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state and hereb a r e 4 w ditieas 9t forth in the
attached Condition's ";.A <I;to a 3£h-T0Wn of South
Windsor standards, httach6d 'csnitions.
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Issued By ---_
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Date Inspected ' n,�p; � ......e�;,,`By
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1.540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: i� rk
Lot
Street No. Street Name
Premises owned by:_ S �xa Q'�c-oo 6 .t-q S 5 L C. C.._
Name of Firm: c) Phone:
Address of Firm: '`L v ,, S tZ ( , 0-4
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main Lay Lateral'for Commercial/Industrial
Building of acres
Connection will be made with �� `` PUC,
Existing Water Supply: Public Water_ Well
Proposed Start Dater � "-1-04 Estimated time for completion idav
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
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the holder of Drain
Layer's License No. _ -o j S:t.& . 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: L /� Print Name: -
Licensed Drain Layer
Date:__. l k-o y
Standard Forms\Permits\APPLICATtON FOR DRAIN LAYERS PERMIT.doe
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