HomeMy WebLinkAboutDrain Layers Permit 109 Bridle Wood Driv TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7011 Contractor PIPPIN SEPTIC SERVICE
Location 0109 BRIDLE WOOD ROAD Address 37 WOOLAM RD
Type Work NEW SAN LAT EAST WINDSOR CT 06088
Phone, No. (860)623-2313
Date Insp Needed 4/z7��Q; Date Insp,. G Z/
Time Insp Needed Tyme tnsp
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Work in Progress
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Permit . 7011 "town of South Windsor, CT
Permit%ate 06/1$/1999
Drain Layer Permit
Expiration Date 07/18/1999
. Dese�rip: `CK 7016
Applicant Location
Name PIPPIN SEPTIC SERVICE , A�dtr, 01._p9 BRIDLE WOOD ROAD
Addr. 37 WOOLAM 2D � w er JCCELLO & IRELAND BUILDERS INC
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EAST WINDSOR CTt3 ';� °x:
Phone No. (860)623-2313 i,
The Drain Layer asks gr e i s aori0 t has �� .1 cense issued by the
state and hereby agree �� 1 c2 �� r s set forth i n the
attached 'Cond i t ions '� Al k h l � �t a with Town of South
Windsor standards, al ) M
J Hemet }end set ched conditions.
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Issued By
Date I nspec �� � tr
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APPLICATION FOR 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:- 1. 61! �a o A Lot #
Street No. Street Name
Premises owned by: V /AIIcx,i Cow s
Name of Firm: P`/Pl- -f s— Phone:
Address of Firm: 37 i O&OW
TYPE OF WORK:
Lay House Drain ; 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 Co gy
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 _Rct ka—d f P6 t l the holder of Drain
Layer's License No. R9 20Q 36, 3� . Only holders of P1, P7 &W9 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.
Signed: Print Name:
Licensed Drain Layer
Date:_
Standard Forms\Permlts\APPLICATION FOR DRAIN LAYERS PERMrr.doc ®N "��
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TOWN OF SOUTH WIND SOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: G �-
BUILDING ADDRESS
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTORS SUPERVIS R (PRINT)
37 vo o la pi-, d --
STREET ADDRESS SIGNATU
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TOWN STATE ZIP INSP N
ED BY TO
�CP D -&I� .23Z72 DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER