HomeMy WebLinkAboutDrain Layers Permit 21 Breezy Hill Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
I
Permit No. 7964 Contrast or CALDETR:Av;.CONSTRUCTION
Location 0021 BREEZY HILL DRIV pdress. °>.580.:FORE'ST RD:...:.
Type Work NEW SAN LAT '
YP y?E:�:.T SU1`FA LD. C'£>_.:.0 6 0 9 3
P'hone:�..No.•;(B;6`Yl,);24.2�:'%0.1.7 •::.
Date Insp Needed Iiati�s -
-----
i
Time Insp Needed Tame Ixy�a �
------------ ----
Inspected B
P Y
Work in Progress —LSr �✓ y.g '
te
i
r
Permit No. 7964 Town of South Windsor, CT
Permit Date 09/21/2005 Drain Layer Permit
Expiration Date 10/21/2005
Descrip: INSTALL SANIT. SEW. ,.LATERA2
A licant
PP
La.t o Name CALDEIRA CONSTRUClf Adc 00 ._ BREEZY H�LL'DRIV
Addr. 580 FOREST RD
:,
OC#Ter LE VASS WAYNE M ::& SUSAN M.
WEST SUFFIELD
Phone No. (860)242-7¢:17.
The Drain Layer ass`i,1rTe1 t}x1siti3f, hasx �t salad lseense assed by the
state and hereby agea`tq.: 1..the" 'erms and con'etit=l.
:O,n_s;:iset::`for. h in the
attached 'Conditions) All wolt` T�alweoidar��e W�tki To)an of South
Windsor standards, a1=1 OSHA"`>requirtircizt at :a' hed::,,coa'ditions.
Issued By
Date Inspected Ins
p --------------------- Ins�sect`er2.;.;,�Y —=----- l
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: Lot #
Street No, Street Name
Premises owned by:
Name of Firm:
Phonet
-
Address.of Firm: U FoC-esq- I
TYPE OF WORK: Q
Lay House Drain / ; Repair House Drain
Lay Main ;
y Lateral-for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water �� Well
Proposed Start Date G Estimated time for completion �3 p
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 o /
Layer's Li ( z the holder of Drain
Y tense 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:
. 'pint Name: ,r -
ensed Drain Layer
Date:
Standard Forms\Permits\APPLICA110N FOR DRAIN LAYERS PERMrr.doc
1 -7
- � t
-g-AD Mal 19 Mal M I I I
r■I r■ r ■ r�
■r r ..r�,�r r■r ■ ■
■■rr■ c,:��r�� ■s■I ,{ ■
rl■ r■ �rr■rrr rr �� . ■
r � ■ ■ ��� r ■
r■■■Ir�lrr■■I■I ■■ �r� : ■■! ■■
No IN■rr■r r� � �r;��■■ r ■
'rr ■r ■ ir_. ■' r ir■
■ k !� rr rr ■ 1��11� �! r rr
Irl.�Ili rr ■ r III I�� ■rr■ ■►
r■■■ rr r ■■■ � r■ r■r■ r
r■�� r ■r r■r �,�■ ■■■rrr■ ■
■ ■� rrr r N rr r
■■II■I■ .� Ir ■ ■r ■■ c,�r ���rr r
r ■r ■'►_ , �■�r■�t11rr■+�'i: _!'r�� r rr
■■�■■■I rr ■�Ir■�� :�r�- �� �'�■rrr