HomeMy WebLinkAboutDrain Layers Permit 75 Diane Drive (2) TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 7824 Town of South Windsor, CT
Permit Date 09/24/2004
Expiration Date 10/24/2004 s,> ,:,+ Drain Layer Permit
Descrip: REPAIR HOUSE DRAIN
Applicant
Name SKIPS SEPTIC
A 11ZNE pR' VE
Addr. 27 MUDDY BROOK ROAD y �WrQysgf ,ALIN IX�TkT�F;Fp1 L & �"
ELLINGTON
Phone No. �:•'
(860)875-2332
The Drain Layer dss ign�t��>���,s
state and hereby agrees: o% 7 ense by the
'�,he term and corm s '
attached 'Conditions All cry, a� y � � set �rh in the
f. .f.Y Y {'ff F 5 jt::ff• .-f ,` Y
�� pxd �ls� with Torn of South
Windsor standards, alto.. OSEIAcjuirniW �s � atagh�d<: osaditions.
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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:_ JR&I C bx- Lot#
Street No. Street Name
Premises owned by:
Name of 155E PTdc Phone: ? SZ 3 32
Address.of Firm: 2'7 /A,- OTaa �LG.l.J C7o,l
TYPE OF WORK:
Lay House Drainer Repair House Drain '
Lay Main - -----; Lay Laterar for Commercial/Industrial
Building of awes
Connection will be made with SIC. zm- 3�
Existing Water Supply: Public Water X Well
Proposed Start Date_ 9-�7-o¢ Estimated tune for completion
ALL WORK-TO BE IN ACCORDANCE WMj,TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS-AND CONDITIONS ATTACHED TO THE PERMIT
Permit-is to be issued to 7 Gv�Iz lc4',� the holder of Drain .
Layer's Llcense No. aq 7?a ,- - 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. 3�a ._ /g gem s�
Signed: Print Name. l &&lz VIZ
Licensed Drain Layer
Date:
Standard Forms\Perm11A\APPLICg10N FOR DRAIN LAYERS PERMIT.doe
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OWNER: DATE:
INSTALLER: ► INSPECTED BY:
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