HomeMy WebLinkAboutDrain Layers Permit 86 Dogwood Lane I
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 7838 Cont or SKIPS"'S'BRTIC
Location 0086 DOGWOOD LANE Rddre$. y.`'%i,27 P BROt�K ROAD
Type Work NEW SAN LAT 3.
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Permit No. 7838 Town of South Windsor, CT
Permit Date 10/08/2004 Drain Layer Permit
Expiration Date 11/07/2004
Descrip:
Applicant y'':
Name SKIPS SEPTIC
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Addr. 27 MUDDY BROOK RC7AD Cii�tir BOWMAN R. CANTON t.,I & BARBARA J
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Phone No (8 6 0)8 7 5-2
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state and hereby age .$to aI1`?<.the"F` msrrd diiiitafi�ns met forth in the
attached 'Conditionsd..
.z�AYl`<Biro�1G>;'Y,s�taa>2::I>Sf�,f'':�.�Z"' ts `t��ri �.-:..w��th `TbWn of South
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Windsor standards, al'1 OSIA'<rfu 'Yem:. $ iad:? "<atG.aljditions.
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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: 'j)66woo-0 Lot #
Street No. Street Name
Premises owned by: I3®w M q
Name of Firm: Sk q7S SF f??C Phone: 8? 5-Z 3 3 Z-
Address of Firm: 2 ? /zc u�'��' �� Z- t-l' 6 ra
TYPE OF WORK:
Lay House Drain---! ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
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Connection will be made with
Existing Water Supply: Public Water x Well
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Proposed Start Date-t h%s. Estimated time for completion
NOTtc9-
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 T74 LkCIT- the holder of Drain
Layer's License No. ZO-7 9 Z T- 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. ��'6 �- 4--1a a o 8-z--
Signe Print Name: -kvz VT`
icensed Drain Layer
Date:
Standard'Forms\Permits\APPLICATION FOR DRAIN LAVERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERA L FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET : 6 DLq;Jooi Leo A e
SUBDIVISION:
NORTH ARROW
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CONTRAC R (PRI T) `` N E),W CONTRACT R S SUPS ISOR (PRINT)
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STREET ADDRESS SIG RE
'A—ii ,k, C'% C)GOZq DATE
TOWN STATE ZIP INSPECTED BY TOWN
97571-Z 3 3 Z DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER