HomeMy WebLinkAboutDrain Layers Permit 40 Brookfield Street TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8136 ConV,-Vactor,FOLS.QM 'CIDUSTRUCTION LLC
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Location 0040 BROOKFIELD STREE ,_;-'*'dXe'kf �138><$YF,':::''STREE`T.,.
Type Work NEW SAN LAT '`f``` '<:,.F .Li,.,.WIN1O C ;<.0607.4
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Permit No. 8136 Town of South Windsor, CT
Permit Date 01/30/2007 '"' Drain Layer Permit
Expiration Date 03/01/2007
Descrip:
„ryApplicant on
Name FOLSOM CONSTRUCTIQN.Lk: s,,,<.......,<' <,x:.. ;:°&c"cYx>:..b>AQ :::$R9I( :h1D STREE
Addr. 138 RYE STREET ".F O :.fir MODZEL ;W:S.KI.-`::TI'i�MA .
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SOUTH WIND SOR C �06>t3''1:`. r13.
Phone No. (860)528-8928::;:.:.::'
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The Drain Layer " s.s , : , 4''ed by the
state and hereby agrees;ta, 4,y- `< _he` d''atteT" ct fn;grs: t :::forfh in the
attached 'Conditions'::. y11Y1'" 'o ?s #r"''`s " zaiC:e : 'thV Tbcx'n of South
Windsor standards, all>. 0SHp % PAI
er#zi'rean Cs;,;; a1 3;:' 1 ' atta' ;tied:;µcox{clitions.
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Date Inspected --------------------- ii 'evte'dI°" y
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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 proposed work:_ 1�i✓ Q I Db We 11 S1 , Lot #
Street No. Street Name
Premises owned by: 1 X o g-tas
Name of Firm:_ 1 O 15E)M c�;oA, LLB Phone:
Address of Firm:_ 138 gyp -4 CT- c)G d`71
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with GIf
P�L
Existing Water Supply: . Public Water Well
Proposed Start Date a=1-c�� Estimated time for completion P-7- clay 5
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 r�2-0^ C-0A-A-QcAi0/) 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.
Signed* Print Name: v4 o
Li nsed Yain Layer
Date: ` �� D
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL . FIELD -- LOCATION
DATE OF CONSTRUCTION: ��� Lo
BUILDING ADDRESS " �� � /��'����
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STREET °
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPEI`ASOR (PRINT)
/39
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STREET ADD ESS . SIGNATURE
066 � DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER