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HomeMy WebLinkAboutDrain Layers Permit 54 Birch Hill Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. Location Contractor A.P. LALIBERTE ENTERPRISES LLC x = VE"1' Address 100 CLARK LANE Type Work t N : COLCHESTER CT 06415-0723 e No. (860)537-6267 Date Insp Needed g/5 n � o� Time Insp Needed i o Inspected By e Work in Progress rrs•� us cC Vb Date Pe-cps t `,No. ' 7474 Town of South Windsor, CT Permi t"' ate 07/30/200"2 Drain Layer Permit Expiration Date 08/2t/2002 Descrip: USER FEE PAID-CK#4728 Applicant Location Name A.P. LALIBERTE ENTER P IKP11<0 4 BIRCH HILL DRIVE Addr. 100 CLARK LANE R RD MARK R & KIMBERLY A I COLCHESTER C Phone No. (860)537-6267 The Drain Layer i as icense issued by the state and hereby ag 1 t and 't' ns set forth in the attached 'Conditions ;n a with Town of South Windsor standards, a e ached conditions. # � lt jt Issued By A Date Inspected e By AP N F PLICATIO OR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR ._ PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Location of proposed work: 'vkc Lot # Street No. Street Name Premises owned by: Name of Firm: Phone: '360 53 7-&Z&"7 Address of Firm: /00 CL4kie C�Yc�ieS cT DlQ�frS--D�23 r TYPE OF WORK: Lay House Drairr X ; Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with l `'wC- Existing Water Supply: Public Water_ Well Proposed Start Date 0� Estimated time for completion Z D6Y5 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 A.-P . LPU-6Cn-%E_ ZgTMs s uc_ the holder of Drain Layer's License No.Cr28o,4A, 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. ,v/R and/or ConnDOT Permit No. CBYD No. 0?642-310/0 (� Signed: Print Name: 4• Z9-uZ�Ke7 -f-- Licens rain Layer Date: Zf D�1 Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc M TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL . FIELD LOCATION DATE OF CONSTRUCTION: g1 BUILDING ADDRESS if N-i[l -owe- STREET SUBDIVISION: NORTH ARROW ------------------ r r � t � + f c yam , t fr t 3 i fi i } t Al ( .__._.. I ! CONTRACTOR (PRINT) NAME CTOR'S UPERVISOR (PRINT) D Bo,r 7L� el Z STREET ADDRESS SIG rokj(v�e GT Ole//�' ��3 � ;� DATE TOWN STATE ZIP INSPECTED BY TOWN - 9(0-o DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER Construction Inspection Report i Project Date f© "' Street Titla /-�A, xjz /he Weather - S�0 ., in Developer Conlr t Work in Pro ess el ? f. ov— c7 i Problem Areas Special Instructions/Orders •