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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7024 Contractor GRANT'S PLUMBING SERVICES
Location 0055 COLLINS CROSSING Address 866 BIRCH MOUNTAIN RD
Type Work NEW SAN LAT GLASTONBURY CT 06033
Phone No. (860)643-6341
Date Insp Needed ( -w �it� Ir�sp. 7�9�9 9 7�3 o A9,
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Time Insp Needed P� Terre Insp; �
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Input Date
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Termit No. 7024
9 Town of South Windsor, CT
Perm"it Date 07/28/1999 Drain Layer Permit
Expiration Date 08/27/1999
Descrip: -CONN CHARGE PAID PREVIOUSLY
Applicant Location
Name GRANT'S PLUMBING SERVICES Addy: Q055 COLLINS CROSSING
Addr. 866 BIRCH MOUNTAIN RD ,.,� ,. Owber p &, M ENTERPRISES INC
GLASTONBURY CT
Phone No. (860)643-6341 f
The Drain Layer asp qnb', thAt ��rm7 t<� �e � gal i d �1''.i cense issued by the
state and hereby agree3 to .4T 1 th e set forth in the
attached 'Conditions' ;A 1 �rk -shy i� ,i n aciahc with Town of South
Windsor s and rds, af'1, .QSii.;� c.u� e � :° and.,` ttched conditions.
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Issued By
Date Insp dBy,
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, Cl-
FEE $25.00
- Ssi
Location of proposed work: �.� CO2L/Ns Lot #___,�_
Street No. Street Name
Premises owned by: b ie t ,4 X/
Name of Firm: /¢/ S &_IZ 1 E(C— S F-fe- Phone: 4!5'2'�
Address of Firm: � 649C /)1 r �� S d�B�/2 f C e
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TYPE OF WORK: 06633
Lay House Drain ,• Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with _ U C
Proposed Start Date 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 �- AM Y � �C 4/ the holder of Drain
Layer's License No. a? 10/2 0T 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.
Signed: Print Name: Z�
Lice ed Drain Layer
Date: 7` ,,2 7.
Standard Forms\PermitS\APPLICATION FOR DRAIN LAYERS PERMIT.doc 4�4
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL `FIELD LOCATION
DATE OF CONSTRUCTION: .M by 30 1R4
BUILDING ADDRESS q . 5o n r�s-e V,'eAj
STREET �'C�►I+�S Gcosc, _
SUBDIVISION: _ duh r;se
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF C Nt CTOR'S SUPERVISOR (PRINT)
') G 1 cT I) TZ A
STREET ADDRESS TUR �
(064 )3 Q DATE
TOWN STATE ZIP INS E ED OWN
-.016O) 6f-)b - Ll 305— DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER