HomeMy WebLinkAboutDrain Layers Permit 299 Clark Street . s
TOWN- OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7016 Contractor TRI-STATE EXCAVATORS INC.
Location 0299 CLARK STREET Address 97C SYCAMORE LANE
Type Work NEW SAN LAT MANCHESTER CT 06040
PhoneNo. (860)647-9224
Date I nsp Needed
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Time Insp Needed f/ 2ft=il Time 'Ins0
Inspected By :lf
Nork in Progress
Input Date
:)errrrit 'No. 7016 Town of South Windsor, CT
Permit Date 06/22/1999 Drain Layer Permit
xpiration Date 07/22/1999
)escrip:
Applicant Location
Jame TRI-STATE EXCAVATORS INN- . � ��o% �� r.t����9 CLARK STREET
kddr. 97C SYCAMORE LANE k Qwer AWRENCE JOHN J . JR.
MANCHESTER CT b� t�' is ¢
phone No. (860 )647-9224
E 7 Ei
The Drain Layer ash n r t °`s p�r�n t as ��d j jcense issued by the
state and hereby agree ; t nd � , t�i s set forth in the
attached 'Conditions k #As n ain with Town of South
Windsor standards , a7 (}Siqu � ttt , � nd � �t ch ed conditions.
L ,
Issued By
)ate Inspected .� s ers =, '
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work: 2 R O-A Zl�- Sr recE' Lot #
Street No. Street Name
Premises owned by: JOH�j UwtzEOC
Name of Firm: IVPhone:—
Address of Firm: Lam/
TYPE OF WORK:
Lay House Drain ✓ ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Proposed Start Date zz 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 the holder of Drain
Layer's License No. 20 3 Cv Only holders of P1, 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.
r ,
Signed� Print Name: ,
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICA1T0N FOR DRAIN LAYERS PERMIT.doc
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL -FIELD LOCATION.
DATE OF CONSTRUCTION: IM?A
BUILDING ADDRESS : 2R q CAP- !Sri- koy-7)
STREET
SUBDIVISION: FA I
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRAC f 'S SUPE VISOR RINT)
STREET ADDRESS NAT
�•�( kX 4-IC91 LV, DATE
TOWN STATE ZIP INSP CTED TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER