HomeMy WebLinkAboutDrain Layers Permit 49 Beelzebub Roadd TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7844 ContXactbi.FSFCIY 8-9.-pg IC
Location 0049 BEELZEBUB ROAD ..
AddresmA %27 I Y 7D; BROflg ROAD
Type Work NEW SAN LAT y"' 01 1 '. %
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Permit No. 7844 Town of South Windsor, CT
Permit Date 10/15/2004 Drain Layer Permit
Expiration Date 11/14/2004
Descrip:
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Applicant : "'
Location
Name SKIPS SEPTIC a ss' � i�00/# fi$kZPBUB "GOAD
Addr. 27 MUDDY BROOK R.'A,
JACQUELYN
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ELLINGTON C 30$'llZl ' yc
Phone No. (860)875-2332 )� z ✓>� H
The Drain La er assi Y - xis pet9as :tl�'.alid1
4 �/ + s &e issued by the
state and hereby acrep/� tisk: nkiti r
ael
attached 'Condition ',;:%1�. x ..r
sr St> arh in the
s1��13 kS ^YY1 a� c xvktl T84n of South
Windsor standards, 11"" SF3J"A ��� 3; / P.
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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: 49 cTF€ E (9u 13 Lot #
Street No. Street Name
Premises owned by: sc-4/V C VCC R<w
Name of Firm: ��<P S n c Phone: S 1 J— 2 3.3 Z
Address of Firm: 2 M u- D L 1 c�COo/ �tZ>
TYPE OF WORK:
Lay House Drain X ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 4 Pyc--
Existing Water Supply: Public Water Well X
Proposed Start Date 10 °1-- Estimated time for completion 4-
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. Q'o 71 Z s 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. as U 4�00
Signed: Print Name: '� � -�F� V/Z,
Licensed 6rain Layer
Date:
stand8rd Forms\Permits\APPLICA'ION FOR DRAIN LAYERS PERMIT.doc
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