HomeMy WebLinkAboutDrain Layers Permit 189 Brookfield Stree - I)
Permit No. 6695 Town of South Windsor, CT
Pertn"it Date" 09/24/1997 Drain Layer Permit
E , ri ration, bate 10/24/1997
Descrip :
Apr)1 i car-it Location
Name SKIPS SEPTIC d& . 0189 BROOKFIELD STREE
Addr . 27 MUDDY BROOK, ROAD Owner: PETOCK ANTHONY M JR+MARY A SURV
ELLINGTON CTi06028
Phone No. (860 )875-2332
The Drain Layer assigned thi-s permit has a yal'id. 11cense issued by the
state and hereby agrees to a1 i the terns land conditions set forth in the
attached 'Conditions ' . All wdrk shall be in, accordancef with Town of South
Windsor st nd rds, ail OSH. ' requirements', and the attached conditions
Issued By (` Tfy1e _
Date Inspect _ �__ C ]:nspected By
, L TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6695 Contractor SKIPS SEPTIC
d
Location 0189 BROOK•FIELD STREE Address 27 MUDDY BROOK ROAD
Type Work NEW SAN LAT ELLINGTON CT 06029
Phone No. ( 860)875-2332
Date Insp Needed —� _ `-' _ �_• �' Qt°e Insp. _ ------___�_. __
Time Insp Needed
Inspected By
Wort: in Progress
< o. :,f�,
Input c� `� _._ Date �ic, (�,( - ` __
APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
L 1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
= FEE$25.00
Location of proposed work: /91 Q3IZ 0 0k fl Lot #
Street No. Street Name
Premises owned by: MR AZ Y ` 19770 c k
Name of Firm: cSk ,,P5 11::;'77/C 66 R VIC C Phone: 3.2—
Address of Firm: ?J D V (Fe o 0K 7zb F/-L tAi 67V Aj
TYPE OF WORK.
Lay House Drain >C Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with /�tIG S,)j'z 3
Proposed Start Date C' 2± Estimated time for completion 9 ��
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR
STANDARDS, ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO
THE PERMIT C aYD '7 3 76
Permit is to be issued to 7V)tl tv 41-k iF R, the holder of Drain
layer's License No. o2o 7 7�L S Only holders of PI, 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 7??4fA f5 441- ex W,
L' eased Drain Layer
Date: � �