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HomeMy WebLinkAboutDrain Layers Permit 303 Strawberry Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 7735 Cont:ra'c>t"or CINAI-1- EXCAVATION,LLC Location 0303 STRAWBERRY LANE .A' drea,S P.0.. OX-34b"<.;.. Type Work NEW SAN LAT 4.Lp. LYME CT 063;71 Phone No ($gQ) &,pV 1$21 Date Insp Needed ����04� Date .Ykta ------ --- -- p Time Insp Needed ima Tzss Inspected By ------------ x Work in s Pro res g aCC� ---- - Input � — Permit No. 7735 Town of South Windsor, CT Permit Date 04/19/2004 """ "' Drain Layer Permit Expiration Date 05/19/2004 Descrip: INSTALL LATERAL Applicant t6o@.L ion Name CINAMI EXCAVATION LLB WSERRY TANS Addr. P.O.BOX 340 Ok#her SULLIVAN,;TOWN'HOMES LLC OLD LYME CT. 0371 Phone No. (860)884-1821 The Drain Layer assi,gi-16d th1s: has a Y lid 1'lcerise :;issued by the state and hereby e.es' t a : 'the n il c' rms `ad can'ditio agi ix set.,.forth in the attached 'Conditions' =A7I w© lshal' raecardasiCd. with town of South Windsor standards, all OSHA uir�tnts. and: th>e attached„conditions. r Issued By ----- ,.: — --------------------- Date Inspected --------------------- Th>Sgt`C't>ed'::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:_ r� Street No. Street Name Premises owned by: �� 7Q d"j 4uvuxv Name of Firm: e4Az4,*g,' �.,,.� ,.,✓ c Phone:. &o /pt� Address.of Frm: P_d. ad A L 3:Z, TYPE OF WORK: Lay House Drain_ ,.�; Repair House Drain Lay Main - ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with G ,�✓C Existing Water Supply: Public Water_ Well Proposed Start Date 4112-Zo f Estimated time for completion Z ��►-y� 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 toc-� the holder of Drain Layers License No. _Z:Z-s v. 7 Only holders of P-1, P-7 or W-9 licenses_ will be issued a pen-nit. 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. va 4 t tt© 11 O!i Signed: i«6 Print Name: Licensed Min Layer Date:_ 4 le4 :Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doe TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL -FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS 30� STREET SUBDIVISION: Sew act /�LtX /4I�tIGT (o�r)r�; NORTH RROW a. _ ...._fi.,, � _ • _ • I S ^^,' t� ' I ,- i ` 1 i , k q�/ _ � L k t t i i i t a r t i i i t ; i // ! f t • CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT) STREET ADDRESS SIGNATURE - - - L-7'm Post-W Fax Note 7671 Date ' pages► E TOWN / STATE ZIP To From Co./Dept. Co. L E TELEPHONE;NUMBER Phone# Phone# Fax# Fax# ' WHITE - TOWN PINK - CONTRACTOR