HomeMy WebLinkAboutDrain Layers Permit 6 Brian Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
)ermit No. 6922 Contractor H. W. LEVACK CO.
_ocation 0006 BRIAN ROAD Address 49 MASCOLO ROAD_
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone,, No. (860)528-0131
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Permit No 6922 - Town of South Windsor, CT
Perzrjq tI-'tate 1 1 /25/1998 Drain Layer Permit
Expiration Date 12/25/1998
Descrip:
Applicant Location
Name H. W. LEVACK CO. Addr. ,MQ6 BRIAN ROAD
Addr. 49 MASCOLO ROAD �net01� E ROSEANN Z
SOUTH WINDSOR CT 06{7n4
I
Phone No. (860)528-0131a
ski r d t ;
The Drain Layer as d this permit etas valaid license issued by the
state and hereby agree tea ; 1 '�tl � � end " tJ s set forth in the
attached 'Cond i t i ons' A 1 wi�k shy l bn acodace with Town of South
Windsor standards, all; OSHA rOcIUi r, i�+' t-" . 4 nd the 't hed conditions.
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Issued By � t
Date Inspected �. �
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:`' czw�
BUILDING ADDRESS 22&
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CO TRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGN E
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVANAVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work--_ , 1 Lot #
Street No. Street Name
Premises owned by:
Name of Firm: /� 1�� y=f/��-��� Phone:
arc
Address of Firm: 16
TYPE OF WORK. ,
Lay House Drain l/ Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Proposed Start Date/� `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 171— the holder of Drain
r e
layer's License No. Only holders of P1, P7 & W9 licenses will be
issued a permit. Permit will expire thirty (301 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 %
Li ed Drain Layer
Date: �/