HomeMy WebLinkAboutDrain Layers Permit 1103 Dzen Way TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8016 Cont.xa`d'tor TERRA 'E'XGiVATION LLC
Location 1103 DZEN WAY At[dres.&:;+ 121.'f)AIaVILL'E:.,.SCHOOL RD
Type Work NEW SAN LAT ktI.LL,I.NGTON:u (.Y 4..79
Phone-Na ( EO)429 4`880
Date Insp Needed 141106
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Time Insp Needed N e :<
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Inspected By -1Se�_'^_�_ ..—
Work in Progress
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Permit No. 8016 Town of South Windsor, CT
Permit Date 12/28/2005 Drain Layer Permit
Expiration Date 01/27/2006
Descrip: SEWER CONNECTION
Applicant
x< Location
Name TERRA EXCAVATION -1jL;.C ..3�IASP-_
Addr. 121 DALEVILLE SCHOOL RD
OGITler ISULLIVA14 T . HOMES LLC
a
WILLINGTON C2 0279
Phone No.
(860)42 9-4 :
8.8
The Drain Layer assigned the s p� {tttT his a1x 7 ipnse •. svied by the
state and hereby ages tv11-. :the "£erms` and cancli-tans> si t:.,:. orth in the
attached 'Conditionsi.. `171 wok..shl `a6tirdantA"grith To of South
Windsor standards, all OSHA requirsms�tS� eid tie atteehed:eoditions.
: s ,
Issued By —)41—
ate Inspected
--------------------- �nsp��t`ed' BY
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT ale— ` 3
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: Lot #
Street No. Street Name
Premises owned by:
Name of Firm: T r't4 Phone�A JOX9 - 08 7
Address.of Firm: S A.`r A.
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main .
Lay lateral for Commercial/Industrial
Building of acres
Connection will be made with Q 3
Existing Water Supply: Public Water Well
Proposed Start Date // o< 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 the holder of Drain
Layer's License No. .7,990 -1 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 9S.Z
Signed:
Print Name:_
Licensed Drain Layer
Date:
Standard Forms\Permits)APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH ANDSOR
SANITARY
- SEWER LATERAL FIELD - LOCATION
DATE OF CONSTRUCTION: - 6
)/03
BUILDING ADDRESS C,44
STREET `'t
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
14 &J �) l 14 DATE �
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TOWN STATE 21P INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE TOWN - PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER