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Home My WebLink AboutDrain Layers Permit 47 Breezy Hill Drive i TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 7912 Corktct"or SKIP `'*SE:gTIC Location 0 7 39,)MRZY HIT,I, DRIV ddreO.� ?:'sY 27:J9 �7'Y B1Yt1QK ROAD Type Work NEW SAN LAT A"Vt ;'sP7S,,INGTON. CT O''6029 Date Insp Needed s ' a T3aia� Time Insp Needed Inspected By /� _ 7; v x d � - Work in Progress _L�t ►'AC TSPb+Y > > k kS b"a t o 1 Permit No. 7912 Permit Date 05/04/2005 Town of South Windsor, CT Expiration Date 06/03/2005 '`` �a�f:,,. Drain Layer Permit Descrip: "..4 Applicant v.,..; h ` s,z ;` >! aca ;ion Name SKIPS SEPTIC a a ti az3 r u©T3$ SREF.GY RIV 13 ,D Addr. 27 MUDDY BROOK ROAD ; X.LL �. xS� DENN, : BAPRA F KM ELLINGTON & 06029 t rf' No. Phone (860) 875-�3�`�r. a� i . :. AE t>�{ c£K Y ]$ r.. i Th e e Dr ain in L a e r:. ;.�ev< s si: Y '':riF�B-�>'�- 5:.. this : :s i state and hereby a F> d by the Y Yxe s:< ;o`.al' ;:a h e x.t: c o 'Con ;x.- >:;,;s�;> >;-.10. ,: ri '.r's e=.t:«;f v�r t h i n t h e attached Conditions '" All>,,.:;...z "su<f-= ::.,:,<:,... wa:rks.ha � y:t>� 3cg :�3ari.c.e,`iv "th M1Town of South Windsor standards, a h OySHA r�qui� m� t� ai the att'achet 'gnditions. Is sued sued By T'Ttle� — — Date Inspected ," --------------------- Inspected By 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: 47 QxnF eZ- y �jj,�,� Lot # Street No. Street Name Premises owned by: N&IS Name of Firm: P,5 � -1;;r7 C- Phone: SZ 3 3 2- Address-of Firm: Z7 /k (� t� c Toa,� TYPE OF WORK: Lay House Drain X Repair House Drain Lay Main--.;- Building o�y Lateral-for Commercial/Industrial acres Connection will be made with �' `` PVC Sb2 3 S Existing Water Supply: Public Water X Well Proposed Start Date 9=o Estimated time for completion �- 10-o.�- 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. _ oZo'l�af 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. C�)-O 0 f /9p 4,2-¢3. Signed: Print Name: 77*7%,f5 1J,1&kCe L' ensed Drain Layer Date: Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc 1 to l l : 1 1 a• •a ■ r er r r e e � ■rrrrr rrr i� �1aii, � ', � �;� �;� rrrrr rrr �! ��3rre 1► rlree ee rr a _-Ier ��» r; ■ e er re a le �. .� � ■ rrr ee ■ 1� � � �, e rrr re rrr eeee r I e e ��.' • eree r e ■ e le � � ■e e rr �i�•��....ar e e ■e r ■r per a eeeere ■ e ee ■ rrr a a• .. 'o a a• a• • a. a a a a' a t a a• .