HomeMy WebLinkAboutDrain Layers Permit 9 Birch Hill Drive i
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No 7933 efitr tp. JIM3;"�S",$ hIYLTMBING SERVICE
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Type Work NEW SAN LATAdST; rWFFFD CT:,06093
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Permit No. 7933
Town of South Windsor, CT
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Permit Date 06/15/2005 "'"
� Drain Layer Permit
Expiration Date 07/15/2005 ' ;^
Descrip: INSTALL SEWER LATER-IC
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Name JIM T'S PLUMBING, S'BR TCE ._ 5 rXg id, „c66'16-5 ` TACTi HtL?RIVE
Addr. 607 SOUTH STONE' STREET, ,# y W%,, OCHFk:�`Y'AETR'A`S.M
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WEST SUFFIELD �/,F��S
Phone No. (860)836-50900.
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state and hereby age•a`es.;t`Q:aa.I's<:the...ae a.}>...>:.:.:9. :: =ta:::1Y' ''s <:a:: o: th in the
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attached 'Conditions,'` All<W*ti.�k5,>.;s�k'al< o ;$; > ; c`Qar .avy'th. T.4wn of South
Windsor standards, a]� O,9-HA �e`quir t{ s ..........a h artt. ohec conditions.
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Date Inspected ......—.........____ Inspected By
.. 71933
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: t ( 1 Lot
Street No. Street Name #
Premises owned by: LAUiV-A M. 5c>Q A.:
Name of Firm: Phone: �"?�-5�OY9
Address.of Firm: t::::- �S
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay-Main - La Y.Lateral-for Commercial/Industrial
Building of acres
Connection will be made with D :15
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Existing Water Supply: Public Water Well
Proposed Start Date sstimated time for completion C
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. 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.
Signed: censed Drain Layer
Print Name:_ fir,*f
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Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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