HomeMy WebLinkAboutDrain Layers Permit 38 Dogwood Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8051 Cont.rartor SKIPS`"S'EP:.TIC
Location '-&6 $ DOGWOOD LANE address:;. :":.27 MUbD.Y�:Bi' 0.,K. ROAD
Type Work NEW SAN LAT
Fu:II INGTCJN 6T .;06:29
Phorml o (80: 875 2332
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Date Insp Needed ------------- _ Date Map
Time Insp Needed Time%In,
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Inspected By 'rs
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Town of South Windsor, CT
Permit No. 8051
_ Drain Layer Permit
Permit Date 05/05/2006
• Expiration Date 06/04/2006 '
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Descrip: i
'Location
Applicant
Name SKIPS SEPTIC Aar 0A38 DOGWOOD ) ANE
Addr. 27 MUDDY BROOK ROAD .S'HERT L is
ELLINGTON CT ::<06029
Phone No. (860)875-2332
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The Drain Layer assigned this pertp�t t?s a xJ: lid l, deri$a issuod by the
state and hereby agree$`t a1T :tile i e and 2�"pxidatioF3s sC forth in the
attached 'Conditions' &dw-all-0 th Town of South
Windsor standards, all :OSHA rsgU?ve :ri: 'i::lz ke>" :he �taGhed conditions.
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Issued By _ ----------------
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Date Inspected T ii .) ;t ed`?_..By ---------------------------
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, Cr
FEE $60.00
Location of proposed work. 3S �>QGw oo-Z)
Street No. Lot#
Street Name
Premises owned byAl
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Name of Firm: Ste(PS 6T P77C
Phone: 7 S Z 3 3
Address.of Firm: 0. 06, 29
4- IV C7V Aj
TYPE OF WORK:
Lay Ho
use Drain Repair House Drain
.Lay Main - .
Lay:Lateral for Co
Building of mmeraal/Irxfustrial
---__acres
Connection will be trade with � �(1C
Eldsting Water Supply: Public Water_?____
Well_______—
. Proposed Start Date r- F-0 6 Estimated time for bon
oomp le �
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ALL WORK TO BE IN ACCORDANCE
ALL OSHA REQUIREMENTS AND WITH TOWN OF SOUTH WINDSOR STANDARDS,
UOND1lIONS OF
TO THE PERMIT
Permit-is to be issued to �� 4,,qz �
Layer's Llcense No. '09 7 . Only holders of P-lthe holder of Drain
will be issued.a permit: PERMIT WILL EXPIRE THIRTY 30 or W 9 licerlses
DATE OF ISSUANCE. The undersigned Drain Layer.here AYS AFTER
-and conditions-set forth in the y agrees to all the terms
Town Street Excavation Permit No. it and attached thereto. Applicant has received
and/or ConnDOT Permit No,
CBYD No. 70 f-�-
Signed:
Pant Name:_ ��
• Licensed Drain Layer
Date:
Standard FM1S\PermitSWPLICATI0N•FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY . SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 15- A 6
BUILDING ADDRESS .�
STREET
SUBDIVISION
NORTH ARROW
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CONTRACTO (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET
ADDRESS SIGNATURE
16/1, /0' 06 D 2" 0 DATE
TOWN STATE ZIP INSPECTED BY TOWN
67S'z 33 Z DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER