HomeMy WebLinkAboutDrain Layers Permit 330 Brookfield Stree TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7903 Coo Y`actor.4 JAME,S tH—R.QWE
Location 0330 BROOKFIELD STREE VAN.'; SOWER ><,SEPTIC
Type Work NEW SAN LAT VEI2 D D:.- VE
�' RDYUN<' £.
Date Insp Needed
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Time Insp Needed
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Permit No. 7903 , ..... Town of South Windsor, CT
Permit Date 04/18/2005 y•<, "<:c::, Drain Layer Permit
Expiration Date 05/18/2005
A ticant :ri': i
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Name
JAME S THROWE
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0'VICVI2'I;DY&.TREE
Addr. VANS SEWER & SEPT.:IC z ? gwf' IRI `TANQ`:tdICHAE, & MARIE
97 RIVERSIDE D ItT�,'..i'
VERNON CT 0606"'
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Phone No. -
860 289 0'
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The
Drain
a Layer*
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state and hereby ag ee <:.t i. 11<{ ., x . �: ,< Q.tId 01t .,t7�is .;8dt"'':f9rth in the
attached 'Conditions' . All work a iYea 2vv"th. T6wn of South
Windsor standards, al" , Op'H1°"x;eFui: tt 'ry' "' ^'Cl; o.ke -conditions.
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Issued By
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Date Inspected --------------------- Inspected By
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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 $60.00
Location of ro osed work: Z� kP,p p �L� �rvvI Lot #
Street No. Street Name
Premises owned by: k e— ri 0
Name of Firm: �-�- sa. T� �., �, �- Phone: .2<6-7 00�-
Address.of Firm: -:z i>iy"rS IL ca S
TYPE OF WORK:
Lay House Drain_; Repair House Drain
Lay Main ; Lay Lateral-for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water..,_ Well
Proposed Start Date 4 & Estimated time for completion
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ALL WORK TO BE IN ACCORDANCE WITH'TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND COND ONS ATTACHED TO THE PERMIT
Permit is to be issued to ✓wc,S ►� the holder of Drain
Layer's License No. 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. JU
Signed: Print Name:,)o��"K 5 l r►� ,
Licensed Drain Layer
Date: 0 G
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrF.doc
TOWN OF SOUTH WINDSOR
SANITARY - SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET : 9r0ak"e�'
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CONTRACTOR (PRINT) N OF CONTRA R'S SUPERVISOR (PRINT)
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STREET ADDRESS O NATURE
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TOWN STATE ZIP INSPECTED BY TOWN
R(7 C'O j DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER