HomeMy WebLinkAboutDrain Layers Permit 114 Benedict Drive j
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7252 Contractor SKIPS SEPTIC
Location 0114 BENEDICT DRIVE Address 27 MUDDY BROOK ROAD
Type Work NEW SAN LAT ELLINGTON CT 06029
_ Rhone No. (860)875-2332
Date Ins Needed
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Time Insp Needed ,me�; Insp /�- 75r 0
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Input' Date
P ,rmj,�t,,-No-. 7252 Town or South Windsor , CT I°
Per"-t to 03 27/2001 Drain Layer Permit
E41 rp'tion Date 04/26/2001
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Applicant Location
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Name SKIPS SEPTIC Addr " `fl114 BENEDICT DRIVE
Addr .. 27 MUDDY BROOK, ROAD oVW66r XUL-AS CECELIA G
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ELLINGTON CT
Phone No. (860)875-2332 =
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The Drain Layer ads i nevi arils pi6rmi t his a valid 1"i cense issued by the
state and hereby agrees 1 fi k= tie t'0 fond t ohs set forth in the
and
attached 'Conditions '- A = work shag in atoordancb with Town of South
Windsor standards, a fi t S} R regL `obtt " and tote+ attached conditions.
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Issued By
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Date Inspected
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS -IN M Nl 'OICT (X
STREET
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CONTRACTOR (PRINT) NAME OF CON CT0 'S S PERVISOR (PRINT)
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STREET ADDRESS SIGNATUR
DATE
TOWN STATE ZIP INSPECTED BY TOWN
60 ��S" ;r33a DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
APPLICATION FOR DRAIN LAYERS PERMIT 7 Z SZ_
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WRYDSOR, CT
FEE$25.00
Location of proposed work 114- Oeld I PfC Ptc Lot #
Street No. Street Name
Premises owned by: C'EC1,_1/) k"1 ,q S
Name of Firm: cS°Kte-5 �,S'FP77C- c5FT-ViC e— Phone: 77 s- Z 3 3 2-
Address of Firm: 2,2 M g 7W flzayi_, 1zD� e 44.1 467zA
TYPE OF WORK.
Lay House Drain Repair House Drain ;
Lay Main ; Lay Lateral for CommerciaVIndustrial
Building of acres
Connection will be made with cr yC,
Proposed Start Date i 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 -am 1V(Ti-Ke_tz, the holder of Drain
layer's License No. Z# 71 z.- . Only holders of Pl, P7 & W9 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.
Signed: Print Name C alc_ '2 Itz,
= L ensed Drain Layer
COW) 2001 `2cl z C//
Date: 7`Z 01