HomeMy WebLinkAboutDrain Layers Permit 82 Bailey Circle TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 782e , Co cto OUBI,.E QNSTRUCTION LLC
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Location .Aa O ` bX�&'�85 45'>.,tEVANS RD
Type Work `f�IEW SAN LAT R� i�C j31T,L°ACT 06' 67
Date Insp Needed z?7�
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Time Insp Needed 7
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Permit No. 7828 Town of South Windsor, CT
Permit Date 09/28/2004 Drain Layer Permit
Expiration Date 10/28/2004
Descrip: LAY HOUSE DRAIN ">F
Applicant y' ' LoC'etion
Name DOUBLE C CONSTRUCT-1.f 33 xLL �r D C"tf2CLE
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Addr. P O BOX 785 45 EVAN F Iy' az W y�`iA s RpOIt A 3-$OCIATES LLC
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ROCKY HILL f CT 960G7x
Phone No.
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The Drain Layer.,,ass gzec tlY�s per rk �� &slid �. s*0 issged by the
state and herebya r fad. ' ' `
6 >q,.a. #1'p`:; ,. . '. t i obi$:;; et;,fort, in the
attached 'Condition' Ald s c, sfi 1 r4 �i a ce �Ffth Town of South
Windsor standards, a 1<.ifiSH ;s''u �stt r !& € Fy sYt�sacd ctxniitions. ;
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Issued By T. L�
Date Inspected � /
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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:_
Street No.
Street Name
ti Premises owned by
Name of Fitrm:= ram assPhone:.
Address:of Firm:_ 1/2rnbn , C
TYPE OF WORK:
Lay House Drain V Repair House Drain
Lay Main
Lay Laterar for Commercial/Industrial
Building of acres .
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date 1<3q Estimated time for completion
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.
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Signed: � �� Print Name: �s
Licensed Drain Layer1
Date:
: ,Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc _
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