HomeMy WebLinkAboutDrain Layers Permit 901 Dzen Way 1
TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 7841 Con�,rtletor TERRA "h'XGA,.VATION LLC
Location 0901 DZEN WAY adze }121<h ILliE:..;SCHOOL RD
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Type Work NEW SAN LAT
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Date Insp Needed Will COa{ii
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Time Insp Needed "
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r Permit No. 7841 Town of South Windsor, CT i1
Permit Date 10/15/2004 Drain Layer Permit 1
Expiration Date 11/14/2004 III
Descrip: LAY HOUSE DRAIN �% •j
Applicant ✓3 `` ec% x, Lat'?ion
Name TERR
A EXCAVATIO
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Addr. 121 DALEVILLE SCSTHOOLF'D f a er SULLIV3IJ.:.. Q :N 'TTOM S LLC
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WILLINGTON :T?..'029 i.-.
Phone No. 860 429-4d8&:-<
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The Drain Layer > s'St ;gr3r. is 's'4;,; t ,r s:3 "id 1 ` 5 jed b the
state and hereby a s. ^%"
Y g e Ott the' `rtt[s d Urlu.LL.`b. het': forth in the
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attached 'Conditions`; :3 i'11` vlt: 1C,4s1t M r'a n.oe oay�tli Zo*n of South
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Windsor standards, aT' OSHA'` i u m?, I il'Amg. Se atb.- el;,.9''e itions.
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Issued B "' :1 :• '
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Date Inspected --------------------- �P'i� "xBy ----------
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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: 9a/ D Z r-.W u_rAa ,4 Lot # �
Street No. Street Name
Premises owned by:
Name of Firm: cc+c. CxC'U a>n _tie... Phone: "o &6-0
Address of Firm: /at DcAQ_,A\Q Smoot Cl Its „ kb ct o627 9
TYPE OF WORK:
Lay House Drain t--- ; 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 Estimated time for completion / W
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 PeN �m the holder of Drain
Layer's License No. . 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. .t.0 v!( 4/2.01 G o 7
Signed: Print Name: Pe't-r'r-
Licensed Drain Layer
Date: l o - ! S-o 1-{
Standard FormAPermits\APPLICATION FOR DRAIN-LAYERS PERMIT.doC
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: �G 2� Qog
BUILDING ADDRESS .g 01
STREET
SUBDIVISION: eri
NORTH ARROW
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CONTRACTOR (PRINT) AA �� NAME Of CQWTRACT9R'S SUPERVISOR (PRINT)
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STREET ADDRESS SIG NA RE
iv{o� CT� DGZ�Y DATE
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TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER