HomeMy WebLinkAboutDrain Layers Permit 35 Diane Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7845 Copuracto.x'y#JAM' k T T1t9 E
Location 0035 DIANE DRIVE 11d s;s VANffieRSlR„&"S. PTIC
Type Work NEW SAN LATR :3LRS'IE<'DRYVE
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Permit No. 7845 Town of South Windsor, CT
Permit Date 10/21/2004 m"" Drain Layer Permit
Expiration Date 11/20/2004
Descrip: CK 5035 $60.00 VANS/. K:x;-7 6 $16<? ,p •.�S.�EL Y'. ".
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Applicant >:_ liRcat` on
Name JAMES THROWE f wrf}€x01
� �d: : SsJJITNE DR .�IE
Addr. VANS SEWER & SEI�TIC` „<�SEELE_ :#FRETIRICK & SUZANNE
97 RIVERSIDE DRFTV "r: 3` is yx a r
VERNON 06066. k Fz
Phone No. (860)289-0(395 ;.
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The Drain Layer 'aSsi greetekis pks �Y� 3 ine sed by the
state and herebya e .t.t ' '1 hex<terms and fcondq `'ae . ,oath in the
gr biz : s> e - � n > flEl
attached 'Condition4� '"All w 9£ s a < Gorda s � v3ith Town of South
e aaeh & gWindsor standards, SftA qeu nditions.
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Date Inspected Inspected By
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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:_ �S �ra_�- j( Lot #
Street No. Street Name
Premises owned by: F..,c d
See LA
Name of Firm: Gr-b J)'t �+�'
- uN Phone: G�
Address of Firm: l 7 K, ►�e-C��r. �rnb,1
TYPE OF WORK:
Lay House Drain_; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with k i3T
Existing Water Supply: Public Water Well
Proposed Start Date .1's-0 Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CON ITIONS ATTACHED TO THE PERMIT
Permit is to be issued to fdvU the holder of Drain
Layer's License No. D-02 6 Y . 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. -200'( '/3(5 OF 2
Signed: Print Name: A 10
Licensed Drain Layer
Date:_o�IOU O�
"' Standard Forms\Permits\APPLICATION`FOR,DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH ANDSOR
SANITARY - SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET : tlaru'— C(r-
- SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CO NT OR'S SUPERVISOR (PRINT)
STREET ADDRESS I NATURE J
V. G ��CLL� G l6!?� � DATE
TOWN STATE ZIP INSPECTED BY TOWN
- 1� i 17 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER