HomeMy WebLinkAboutDrain Layers Permit 46 Dogwood Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. Con.kralctor CONSTRUCTION WORKS
look-
Location /Xdd�;eg.(3:� 18 SE.YM UR F2OAp
Type Work RPR SAN LAT Y1I>NUS.,QR"L K$> (it' .06096
Phones: 70 E 8 GQQ')2 2 1.913
Date Insp Needed 3
�- Date Ih�s
t
llJ
6 1
Time Ins p Needed �i
1
Inspected By 1l
Work in Progress ��� �- r r 1f s z'g!
.�` ret'l�u a
a o
„
r
Input mate
s^ -------------
Permit No. 8042 Town of South Windsor, CT
Permit Date 04/07/2006 Drain Layer Permit
Expiration Date 05/07/2006
Descrip: REPAIR SEWER LATERAL; ' `
Applicant L""�'a:t on
PP c3 �..
Name CONSTRUCTION WOR .•I7::' N ...S ._. i`._'7>x;',ct «``'Q „s!D`pGWOO. E
Addr. 18 SEYMOUR ROAD Oftler LEWIS E2}NAIkI3::. J' & JANE M
WINDSOR LOCKS CT ._06096
Phone No. (860)292-1913 ...
TheDrain Layer
a ``3"' ensue :::.'. ed b the
ssd.. k�. s : ` :`'h. s'_`'a. _a. 1.d..1; 'ce �.:�au
state and hereby a ree: :3"tcs.'> `1"_:.he"t`ermb"aYd'Vc:tiY <" `t:: or°h in the
attached 'Conditions f 111 WgXk shall::;�i'�<:>��t :4*�z�rda�ee wit. Toph of South
Windsor standards, all: OSHA `re.q.uirezde .(..6—arti'; kre atta:§hed--,con'ditions.
���v✓y %%7;
Issued By ------ Ts•tle. � .- j!-'� V --------------
Date Inspected I ns'13 'Ct`e ct"'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: z i CO&OO gyp¢-"JC
Lot
Street No. �
Street Name
Premises owned by:—4 �
Name of Firm
Phone:
Address.of Firm:
of/
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 Date./2—
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
Layer's License No. the holder of Drain
will be issued.a � n Y.holders of P-1, P-7 or W-9 licenses
permit. PER WILL EXPIRE THIRTY(30)1DAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terns
-and conditions set forth in the permit and attached thereto.
Town Street Excavation Permit No. Applicant has received
and/or ConnDOT Permit No.
CBYD No. a96 ,52 7 99
Signed: � .
Licensed in Layer
tint Name: ® -� �/`�
Date:
Standard F0rms\Perm1ts\APPLICM0N FOR DRAIN LAYERS PERMIT.doc
TOWN O SOUTH WINDSOR
SANITARY SEWER L ATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 13
BUILDING ADDRESS
STREET
SUBDIVISION:
NORTH ARROW
f , UA
Lj—
woe
00
,
CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT).
STREET AD/D'RE �f SIGNATUR.--Wt ell,
DATE
T STATE/ ZIP INSPECTED BY TOWN
DATE
LEPHONE UMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER