HomeMy WebLinkAboutDrain Layers Permit 161 Beelzebub Road (2) r
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7 Contractor S. J . HOFFMAN
Location 0161 Address 77 HOFFMAN RD
Type Work SAN LAT ELLINGTON CT 06029
Plhone No. (860)872-8375
Date Insp Needed G.A L-
Time Insp Needed <: TimefLrsp3
Inspected By f-'r✓ `�
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Input �+ Date
Permit No. -7330 Town of South Windsor, CT
Permit Date08/24/2001 Drain Layer Permit
Expiratio ,-Pate' 09/23./2001
Desp_rip:
Applicant Location
I
Name S.J . ROFFMAN Addr. 0161 BEELZEBUB ROAD
Addr. 77 HOFFMAN RD Owner REYNOLDS WAYNE L & GAIL L (BURN
ELtINGTON CT 06f� 9
Phone No.' (860)872-8375
The Drain Layer assigned this permit has a valid license issued by the
state and hereby agreo, 11 f en s and 0 odt�tfo6s set forth in the
attached 'Conditions' All _ k sh_al1 b . n aprdanpe with Town of South
Windsor standards, all `OSHA: req:l',,iments, ;;and t e `attached conditions.
Issued By t' A .► tr• �a
Inspeato Date Inspected gy id j
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WIN'DSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work: f ��l Lot #
Street No. Street Name
Premises owned by: t
Name of Firm: s /T ,� C Phone: T( I J)
Address of Firm: !�� �►� _ � �.
TYPE OF WORK:
Lay House Drain i0� Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with Sb k --?J—
Existing Water Supply: Public Water Y Well .
Proposed Start Date ° � Estimated time for completion G
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 S t A* /41 a� the holder of Drain
Layer's License No. —")? 2 ? . 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. and/or ConnDOT Permit No.
CBY'D No. '?0 J
Signed: _ Print Name:
Linen Drain Layer
Date: ? -? / ' 0 /
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: r��T 2® ®
BUILDING ADDRESS 171 4�2-L Ze-Bva R
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT).
STREET ADDRESS SIGNATU E >
Z/L 17�G? u�✓ C T ®� (�2 p �' �/�,� .u/� DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
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