HomeMy WebLinkAboutDrain Layers Permit 903 Dzen Way e
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7843 Cont, at yTERRAXVATION LLC
Location 0903 DZEN WAY s 0'w,
Fft•(_dzes.tlz< 121 h STILli' ».:»SCHOOL RD
Type Work NEW SAN LAT 'L s "
Yp :ljf..I,NGtOMs�CT 0162.79
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Date InsNeede d �✓ 1
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Time Insp Needed � e� I � �h
Inspected By
Work in Progress
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Permit No. 7843 Town of South Windsor, CT
Permit Date 004 10 15 2
/ / Drain Layer Permit
Expiration D
p ate 11J14/2004
Descrip: LAY HOUSE DRAIN / <
Applicant f :"r£ ''. `: LgaX`' kon
Al
Name TERRA EXCAVATION,'LL T(EN
Addr. 121 DALEVILLE SC."$OOL R- ': t f"r_SULLIV7�N..:. ON3N"AOM£S LLC
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WILLINGTON ai'- �2 0i>9
Phone No. (860)429-488fF -_/ ;a 'x• "`"`
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The Drain Layerssirjrekd �s � kzsa �d lE3o�n�ie ed by the
state and hereby agregz tc� l sth eerms sand c I Wet forth in the
attached 'Conditionsa 11A `
. 8 ' 'o Ciaz '.v t: T'o n of South
Windsor standards, a] _ OSI{A`` 3' "uir ?t,1 :' 4e at.f' heCo.tditions.
:
Issued B r
Date Inspected
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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: 903 X>Z d2lt W A Y Lot #
Street No. Street Name
Premises owned by:
Name of Firm: c.cc. Phone: "o —*3q--qa-o
Address of Firm:_(21 brAtaAke_ SCL.eal fi,'A W,11.a ."14 C-17 oto21-3
TYPE OF WORK:
Lay House Drain ; 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 a Estimated time for completion / (�u k
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 C— S6%\On 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. ko a q Y 2. n 1 G o 7
Signed:Z,0� —
Print Name: Petz f S N
Licensed Drain Layer
Date: -/0-15 -e? c/
Standard Forms\Permb\APPLICATION FOR DRAIN.LAYERS PERMIT.doc
y TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: ocT, z I goal[
BUILDING ADDRESS q 0 ,3
STREET : 1) gA/ td.4
SUBDIVISION: F,
INOROW `+• qav
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CONTRACTOR (PRINT) NAME 0 ONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
DATE
TOWN
STATE ZIP INSPECTED BY TOWN
�b 6 o) W !�—M DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER