HomeMy WebLinkAboutDrain Layers Permit 1101 Dzen Way TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8017 Cont;j:. Ctor TERRA"EXCAVATION LLC
Location 1101 DZEN"WAY` Ai dregi 2 ,'`:=..121.:DAU EVIL-TE..,.SCHOOL RD
Type Work NEW SAN LAT 411.�ING°TO31<'CT U`6;279
Phone .N.o {&gip"),4 a918 a.0
Date Insp Needed —
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Permit No. 8017 Town of South Windsor, CT
Permit Date 12/28/2005 Drain Layer Permit
` Expiration Date 01/27/2006
Descrip: SEWER CONNECTION
Applicant t
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Name TERRA EXCAVATION LLC d ;Q1 Z1314 kA..
Addr. 121 DALEVILLE SCHOOL RDSULLIVpt"TOWN HOMES LLC
WILLINGTON CT :Of279
Phone No. (860)429-48.80.
The Drain Layer assigned thls 'p :r. t t ,his ?rah,%.cl: 1'icexise asued by the
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state and hereby agree's to a1 the terms and conditzona set forth in the
: : .::%:':�i�::i::i::>iYi3+).::�:::�Y::': •'::�:.:....:i.
attached 'Conditions'::,."'All`:iaor <sli: a7:::b <;zri:iCos:da'n:�e.':wat•h ToWn of South
Windsor standards, all.. OSfiA zequire(nex�ts, and .k.th att'aoTied :coriditions.
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Issued By ---
Date Inspected Ins e"c""'E'ed B
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APPLICATION FOR DRAIN LAYER PERMIT C y� $.. q7 f
` TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: 11 o f d/. Lot #
Street No. Street Name
Premises owned by:
Name of Firm:— r CAaha, �.0
Phone:- Z5C-zo ?.
Address.of Firm:_ /4 ✓' p , �F -0 5,,,,[z // j�
TYPE OF WORK:
Lay House Drain Repair House Dfi ain
Lay Main L.ay Lateral for Comnierciai/Industrial
Building of acres
Connection will be made with _ Ave- - sjj
Existing Water Supply: Public Water ✓ Well
Proposed Start Date / c ✓o G 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 Tie,, the holder of Drain
Layer's License No. / 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. �sSS`,�
Signed: Print.Name:_ �-
Licensed Drain Layer
Date:�lti
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr.doc
TOWN OF SOUTH. ANDSOR
SANITARY SEWER LATERAL '. FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS : // ' �,
STREET
-I- SUBDIVISION: � L,,Lei 1,1
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NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTORS SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
6-/ct d'� c DATE
TOWN /STATE ZIP INSPECTED BY TOWN
7�0 DATE
TELEPHONE NUMBER
WHITE TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER