HomeMy WebLinkAboutDrain Layers Permit 100 Dawn Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No.. , 7586 Contractor ROOTER EXPRESS
Location O1O0E-4 DRIVE Address 84 ALEN DRIVE
Type Work RPR SAN LAT WEATOGUE CT 06089
ION S hone No. (860)246-7824
Date Insp Needed lmo e sp.
3 2�oZ
Time I nsp Needed
Inspected By
Work in Progress or avos -oo'r
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Pe A t No. 7586 Town of South Windsor, CT
.Permit Date 10/03/2002 Drain Layer Permit
Expiration Date 11/02/2002
Descrip: REPAIR HOUSE LATERAL
Applicant Location
Name ROOTER EXPRESS C 4W r 0100 DAWN DRIVE
Addr. 84 ALEN DRIVE e OSS JEFFREY A & LISA MARIA (SU
WEATOGUE
Phone No. (860)246- 82Co
The Drain Lay r it d license issued by the
state and hereby a ms nd tions set forth in the
wr,
attached 'Conditi vvi, ance with Town of South
Windsor standards A attached conditions.
Issued By J t l t�
Date Inspected ed By �/ '�
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: c-"lv Lot #
treet No. Street Name
Premises owned by: 4
Name of Firm: S Phone:
Address of Firm: iv
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 Date40 _o�L— 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
s
Permit is to be issued the holder of Drain
Layer's License No. 9W Only holders of P1 or P7 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 b
conditions set forth in the permit and attached thereto. Applicant has received Town
Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No. o .
Signed: Print Name:
Lc sed Drain Layer
Date: AX
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 10 Q 2-
BUILDING ADDRESS l00 �GUIN ►� r�
STREET `oa S ,uj.
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
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