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HomeMy WebLinkAboutDrain Layers Permit 06 Bancroft Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT ermit No. 7289 Contractor CORREIA EXCAVATORS INC , Location 0006 BANCROFT LANE Address 47 SMITHBROOK TERRACE Type Work NEW SAN LAT GLASTONBURY CT 06033 Phony No. ( ) - Date Insp Needed1. /0/ Date Insp. Time Insp Needed " i Inspected By Work in Progress L �•rcy �,� 01 r / 0/z e le Input' CIw Date D Permit No. 7289 Town of South Windsor, CT Permir& _ ate .06/13./2001 Drain Layer Permit Expirat1on .Date107/13/2001 Descrip; . CONNECTION FEE CK512 USER CK#513 Applicant Location Name CORREIA EXCAVATORS INC Addt 0006 BANCROFT LANE Addr. 47 SMITHBROOK TERRACEx nwner', FOREST VILLAGE ASSOCIATES LLC GLASTONBURY CT 06043 Phone No. ) - The Drain Layer ash l7 t ov th1. perm�i,t his' A va11.d license issued by the state and hereby agress tea *t1,,;t1A 'te;rms�'end` cohditiArts set forth in the � attached 'Conditions"' `=A 1 t ,vo_ k sh l; �_ a .`fi n aaOogrda' c " w i th Town of South Windsor standards, all ©SH ' r*q. irent ,and the `attached conditions. Q Issued By -- 01 Date Inspected 0*4C11,F`��_ Tntpegte i APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPAR fMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Location of proposed work: �E 20ar o-,, ah4- Lot # `31 Street No. Street Name Premises owned by: Name of Firm: �O/Lr�ac° G��+ -,fin c. Phone: S Address of Firm: 7 7' TYPE OF WORK: Lay House Drain lam; Repair House Drain Lay Main ; Lay Lateral for Commercial/Industrial Building Yo,&4� of, acres Connection will be made with Existing Water Supply: Public Water_ Well Proposed Start Date 3,1 o r Estimated time for completion Oz g W-g-f Gr ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WIN`DSOR STANDARDS, ALL'OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT Permit is to be issued to ho g' Z je a -w e- the holder of Drain Layer's License No. Only holders of P1 or P7licenses 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. 0 9S 0' 4 and/or ConnDOT Permit No. CBYD No, • 0 0 f 610 1 Signed: Pe,,aeC- ,,O . o Q� Print Name: Licensed Drain Layer Date:- 1 � ,1 / standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS STREET X;I- Zar SUBDIVISION: NORTH ARROW t t t t v 1 i �t 1 ; t , i i t t Cep i 1 3 I : I i i CONTRAC (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT) STREET ADDRESS SIG UR 4�,/vllWLe DATE TO STATE ZIP INSPECTED BY TOWN DATE LEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER