HomeMy WebLinkAboutDrain Layers Permit 1201 Dzen Way TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7880 Con;t.ractor TERK'Ai-EXCAVATION LLC
Location 1201 DZEN WAY Addrssss 121 DAL.EVILLE SCHOOL RD
Type Work NEW SAN LAT W;ILLSNGTON CT` Q6279
Phone I7o 4s.0)429'--;4880::..
Date Insp Needed
Time Insp Needed ------____—_ Time .risp ? �3
Inspected By J.
7-7
Work in Progress —_ C1P'/�Uv �(rG1�hti k^ s# �61 _- At A'v
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Permit No. 7880 Town of South Windsor, CT
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Permit Date 03/02/2005 Drain Layer Permit
Expiration Date 04/01/2005
Descrip:
Applicant Location
Name TERRA EXCAVATION LLC Adtr 12E3`1 IiyEN WAY
Addr. 121 DALEVILLE SCHOOL;RD ESwu.er SULLIVAN`-TOWN HOMES LLC
WILLINGTON CT O6279
Phone No. (860)429488(3
The Drain Layer: assigned thisxiatvalid li:cense'�ssued by the
state and hereby agxeens; to a11;_.the terms and c6hda.tid:nl9 set;._fcarth in the
attached 'Conditions' : All work sha13 b i'.xi ccordanc'e.with Town of South
Windsor standards, a].1 OSHA-!,xa.quiremrsts,;;; yd the attached conditions.
Issued By �t_ Title
Date Inspected Inspected By
a
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 a( D Z 6 1) ��� Lot #
Street No. Street Name
Premises owned by:_ Ew(baA.-i 0-at- wcs C
�KG. i/.r f 'o
Name of Firm: f �rya Phone: 4) 1127- yBd'b
Address of Firm: 1 Z i �4�� «c s� IQ.t. G✓�1 l,.,a,f, �.
TYPE OF WORK:
Lay House Drain- -4/. ; 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 3 9 S 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 T rfa n-1 the holder of Drain
Layer's License No. .2 S o5 t S . 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. 2.0 Q 5 Q j 0 o got(
Signed: Print Name: ec
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: as s os"
BUILDING ADDRESS 12 o. I /z o o 3
STREET 'A-1
_ JU SUBDIVISION: & ..
NORTH ARROW
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fe-rro )5k(-.Va�t o n
CONTRACTOR (PRINT) NAME OF C NTRACTO 'S SUPERVISOR (PRINT)
3
STREET ADDRESS SIGNATURE
_ Ltd i ! CT- 27 DATE
TOWN STATE ZIP INS TED BY TOWN
(76 0) 'L/2-f- Y TT9 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER