HomeMy WebLinkAboutDrain Layers Permit 1102 Dzen Way � y
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8015 Con ,ra ER
`d'tor TRA 'E'3{GAVATION LLC
Location 1102 DZEN WAY
d"dre ;= 1, .121:;DAL;E'VILDE.,..SCHOOL RD
Type .Work NEW SAN LAT
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Date Insp Needed ---- 1 144 lj -
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Time Ins Needed
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Permit No. 8015 Town of South Windsor, CT j
Permit Date 12/28/2005 Drain Layer Permit
Expiration Date 01/27/2006
Descrip: SEWER CONNECTION
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Applicant Locat'::on
Name TERRA EXCAVATION LLB Act y.1:g2 AZEN WAY
Addr. 121 DALEVILLE SCHOOLT014.,7 HOMES LLC
WILLINGTON C! 06279
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Phone No. (860)429-4880
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The Drain Layer assigned ChasStns has a va7ad lcensesied by the
state and hereby agrees ;to € 3`.the terms. and conc� gsa s.et ah in the
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attached 'Conditionst All work s vn of South
Windsor standards, all.. OSHA zequirem� s, a�t� .the atta.�hed eoliditions.
Issued By ,,
Date Inspected
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APPLICATION FOR DRAIN LAYER PERMIT
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TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: Z
Street No. Lot #
Street Name
Premises owned by:
Name of firm: lel<c o L[. C
Phone:
Address.of Firm: c A. r�
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main - ; Lay Lateral-for Commercial/Industrial
Building of acres
Connection will be made With 15b43 r v c
Existing Water Supply: Public Water ✓ Well
Proposed Start Date L 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-r ra
Layer's License No. _,� $o si the holder of Drain
will be issued Only holders of P-1, P-7 or W-9 licenses
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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. —o?-oQ S SZ o / S Y'
Signed: Print Name: 4ehrr-,C� ,-if-L
Licensed Drain Layer
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Date:
Standard F0rmskPerm1ts\APPLICAJ10N FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS : 2_ PIPE -�
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME 0 CONTRACTOR'S SUPERVISOR (PRINK
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STREET//ADDRESSS� / 7—
SIGNATURE
44 d 1--yd C 'l7- 6%1 Al d 0 DATE
TOWN STATE ZIP INSPECTED BY TOWN
2q �Z DATE
TELEPHONE NUMBER
WHITE - TOWN. PINK ! CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER