HomeMy WebLinkAboutDrain Layers Permit 51 Bancroft Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7632 Cont.ract'or HODfdMB:..l.FARMS
Location 0051 BANCROFT LANE
Address 25 4ASHING7'O.N RIDGE RD
Type Work NEW SAN LAT .GRANBY C ,060:26
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Time Insp Needed Tina Il3spn
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Permit No. 7632 ;
Town of South Windsor, CT j
Permit Date 05/19/2003 Drain Layer Permit
Expiration Date 06/18/2003
Descrip:
Applicant y LOat"ion
Name HOLCOMB FARMS As3dx -U051 BAp7CRpFZANE
Addr. 25 WASHINGTON RIDGE Rb OWne,r>FORE5T VILLAGE AS$OCIATES LLC
a -
E GRANBY CP 0602"£
Phone No.
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The Drain Layer assigh6a this AN ;
X i:d n6ense i sSued by the
state and hereby agYess tt� all .the-terCnsEan ,
oon��.t�>7ns set forth in the
attached 'Conditionsa All .,work s,hal a &0cQX,anee With Town of South
Windsor standards, all OSHA requir2thk�ts, ant: the attache d conditions. I.
Issued By
...
Date Inspected --------------------- Inspected By
3
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: �CfZot" LA4 Lot
Street No. Street Name
Premises owned by: S-FO" 9.C�"T- ?L—Zjs
Name of Firm: 4nL-C-0 Me f7aT�?'rgn S Phone
Address of Firm: Z=S t+IAGrd-m,.P 'Roue Rb,
TYPE OF WORK:
Lay House Drain_; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with L,ATG--X+ L
Existing Water Supply: Public Water V
Y Well
Proposed Start Date s-1 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. j 0 cZ 5 3-7 Only holders of P1 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: .4!P'1?1WA1j1 U
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 6/21
BUILDING ADDRESS LA4k
STREET
SUBDIVISION: rogessl` l,rLL^9tS- , �C70AJ€C_f-o%t` "-
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIG ATURE / I
7 0 _ 16t 1 L�3 DATE
TOWN STATE ZIP INSPECTED BY TOWN
r t DATE
TELE ONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER