HomeMy WebLinkAboutDrain Layers Permit 223 Brookfield Stree TOWN OF SOUTH WINDSOR INSPECTION REPORT i
Permit No. 8092 Contt•a`ttor.JAME, T CRQ.WE
Location 02 .3'; Address VANS SEWER & S,EPTIC
Type Work NEW SAN LAT
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? RNON CT-:,06`066
fPkiae No { 6�}.2 9 0095
Date Insp Needed
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Time Insp Needed NAM Tie Iriz ,�
Inspected By77
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Work in Progress
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Permit No. 8092 Town of South Windsor, CT
Permit Date 09/15/2006 Drain Layer Permit
Expiration Date 10/15/2006
Descrip: INSTALL SANIT. SEW. ,I1TE17A
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A licant L_"..a on
PP OC .t�..
Name JAMES THROWE >:}3ROOKE;i-it 9:TREE
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Addr. VANS SEWER & SEPTIC 0utner DOWLATS1 $1 MAK 1
97 RIVERSIDE DRIVE
VERNON c o0 o6
Phone No. (860)289-0095.. .:
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The Drain Layer as:s'lqf" ' ned tlrs':jE :: 11s tx, I*d lfcense .assued by the 1
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state and hereby r' "1_`-> h "'''r "e eby ag ,ee: 'tQ:.''<a.l. ..t e Ce" ms'':`ari'd cnft'd'3t.�pxi:�i<> �t:: forCh in the
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attached Conditions .:..�1�11''_ ' :3s`a'ITa1`5�€raa�`'>:.`« '��Yc�an:�:��`.w"t Tbvth of South
Windsor standards, all:. OSHA''re'ejnreiria axe�' ,kte_ att:a - ed;:,cor'ditions.
Issued B ��—�1✓��A Title:.: --- �
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Date Inspected --------------------- Irispe'ct' tl"::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: of a 3 6w0 k. r,/ Lot #
Street No. Street Name
Premises owned by: r---
Name of Firm: � h
-- ,i mac, IV)Le LLCPhone:2kLWjS
Address.of Firm:TYPE OF WORK:
Lay House Drain : Repair House Drain
Lay Main_______:_; Lay.L ateraf for Commercial/Industri l
Building of acres
Connection will be made with SrJ 3
Existing Water Supply: Public Water 'C Well
Proposed Start Date 2 � 06
Estimated time for completlonj_�;- �_
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 tor�„�
Layer's License No. aorr L 3 g
Will be issued.a permit: PE the holder of Drain
. Only holders of P-1, P-7.or W-9 licenses
RMIT WILL EXPIRE THIRTY(30)°DAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms
-and eonditions-set forth in the permit and attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No.
..Signed:
Print Name: fir.w-5 re Licensed Drain Layer
Standard FOMAPermlts\APPUCATION FOR DRAIN LAYERS PERMIT.doc
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD ' LOCATION
DATE. OF CONSTRUCTION: 91
BUILDING ADDRESS 2 3`
-STREET .cajak& I A `�5 re
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (WINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
'7 ►l�rg i t 2`7 0 6
STREET ADDRESS SIGNA DATE
TON STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
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