HomeMy WebLinkAboutDrain Layers Permit 320 Diane Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8095 ContraC tor `SKIPS SEPTIC
Location ; ITE pp,;VE .;Address; ``s:27 K;bDy BROOK ROAD
Type Work NEW SAN LAT ........,,kL:LINGTbN;` T..060.29
Phone-'.No _(8&Q)875532
Date Insp Needed _�^� `—CAVq I _ Dat0 Insp —
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Work in Progress
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° Permit No. 8095 Town of South Windsor, CT
Permit Date 09/21/2006 Drain Layer Permit
Expiration Date 10/21/2006
Descrip: INSTALL SEW. LAT. & PUMP,:dHAMBEP_{_
Applicant =" Lo tion
Name SKIPS SEPTIC dC 03 0 AIA
Addr. 27 MUDDY BROOK ROADtN .D DZAIVE MARZE
ELLINGTON CT,06029
Phone No. (860)875-2332..
The Drain Layer as91gbed tk1 s persn t .k s a valid 1 c Ysse issued by the
state and hereby agrees:. to il.I the t���f€� and c.o:i�d3.tiar�s set;:forC'h in the
attached 'Condition4.' -;31 wads skims b�::.in accerdan a Math' Towai of South
Windsor standards, :0-Venf�
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Issued By
Date Inspected Inepe ted B
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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
WA( C-01) .
Location of proposed work: 300 D 1-9-4-C Lot#
Street No. Street Name
Premises owned by: 4A-E C 47z AI 0 L .
Name of Firm: Phone:
Address-of Firm: a- _90�- 7-7 2 7 u?�y �itoal�
TYPE OF WORK:
Lay House Drain Lay Main Repair House Drain
- - -
Lay Lateral'for Commercial/Industrial
Building of acres
Connection will,be made with 3 r '(;>V C_
Bdstlng Water Supply: Public Water Well
Proposed Start Date-_-YO> _
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 L�f1Ldc�� the holder of Drain
Layer's Ucense No. z� 7 z Only the
of P-1. P-7 or W-9 licenses
will be issued.a permit: PERMIT WILL EXPIRE THIRTY(30)OAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to-ail 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.
Signed: #
g Print Name: '7�� Gulf,L,��T�
icensed Drain Layer
Date:
Standard Forms\PermiMAPPUCATION FOR DRAIN LAYERS PERMr.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: o
BUILDING ADDRESS
STREET : Dj An e
SUBDIVISION:
NORTH ARROW
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CONTRACTORV(PRINT) NAME OF ONT T R'S SUPERVISOR (PRINT)
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STREET ADDRESS i SIGNATURE
c G�QZ�i �a DATE
TOWN STATE ZIP INSPECTED BY TOWN
�757' Z3 3 Z__ DATE
TELEPHONE NUMBER
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