HomeMy WebLinkAboutDrain Layers Permit 43 Bancroft Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7f; Contractor HOLCOMB FARMS
Location Address 25 WASHINGTON RIDGE RD
Type WorktMAN -LAT E GRANBY CT 06026
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Permit Nq 7623 Town of South Windsor, CT
Permit Date 04/17/2003 Drain Layer Permit
Expiration Date 05/17/2003
Descrip:
Applicant Location
Name HOLCOMB FARMS 404 BANCROFT LANE
Addr. 25 WASHINGTON RIDGE 0 VILLAGE ASSOCIATES LLC
E GRANBY CT 0
Phone No.
The Drain Layer as i s a cease issued by the
state and hereby agre d s set forth in the
attached" 'Conditions' k &"c with Town of South
Windsor standards, all ached conditions.
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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 # S
Street No. Street Name
Premises owned by: 94 ,
Name of Firm: Phone:
Address of Firm:__ 2S w�ts�, .� �, �o Ad
TYPE OF WORK:
Lay House Drain n/ew; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water �� Well
Proposed Start Date 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. -Z,& 4, !,�'� Only holders of Pi or P7 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: ,H r R ItA A 41 C
Licensed Drain Layer
Date:_ 3
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc j
- TOWN OF SOUTH WINDSOR
SANITARY, SEWER LATERAL FIELD . LOCATION
DATE OF CON STRUCTION: 12, b�
BUILDING AMRESS q3 .
STREET ' :
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SUBDIVISION: o���sT. 11tb
NORTH ARROW
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PHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER