HomeMy WebLinkAboutDrain Layers Permit 25 Chase Farm Road Permit No. 6628 Town of South Windsor, CT
Permit Date 06/20/1997 Drain Layer Permit
Expiration Date 07/20/1997
Descrip: CK2157 $3875 . 00 PAID LOTS 3 ,4, 9 , 15 , 17
Applicant Location
Name PAUL L. SZEWCZYN-- EX%AVAITOR Addr . �-�5" "CHASE FARM RD
Addr. 490 COLEMAN ROAD 4wner ,CH4S ASSOCIATES
MIDDLETOWN CT 0645"
Phone No. (860)347-8502
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The Drain Layer ass-i gn8d th 3-s permi t;;14s a �.1 j d J.t' ense issued by the
state and hereby agreesll t6`"A�T the terms; :,end cb-td-�.t c�n8 set forth in the
attached 'Conditions' A11 ;dark "sh'* 1 s- ineacc6r-dAii with Town of South
Windsor standards, all' f)SHA rementanrc 1;Yt+es attached conditions.
Issued By _ v� ` —.�1 U,ac= .. - — —_—_
Date Inspectedinspected 8y
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6628 Contractor PAUL L. SZEWCZYK EXCAVATOR
Location 25 CHASE FARM RD Address. 490 COLEMAN ROAD
Type Work NEW SAN LAT MIDDLETOWN CT 06457
Phorlp ,No (8f0 )347-8502 j
4 s
Date Insp Needed D'ate Insp
Time Insp Needed _ rime '` ' f ,44
Inspected By = L �
Work in Progress -1�`� `- ' .�f, }1 ------ - - --
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Input Date "i
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APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH W MDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL -
1540 SULLIVAN A VENUS
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: �- � s-e ``P —.Lot # 3
Street No, Street Name
Premises owned x 9s a et s::& 4 A__L•
Name of Firm: UG e• w ct.VIr e)16 Axe Phone:
Address of Firm: M ccqGeruAti 60 M4,wc6a-,wit,gT
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with fY4
Proposed Start Date Z-3 Estimated time for completion
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 &A . �• SZ2�G2�� the holder of Drain
layer's License No. 4o 2."7<I n/ . Only holders of Pl, P7 8a 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 wG `• Sze wcZd",
Licensed rain ayer
Date: