HomeMy WebLinkAboutDrain Layers Permit 65 Edgewood Drive 4
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7127 Contractor H. W. LEVACK CO.
Location 0065 EDGEWOOD DRIVE Address 49 MASCOLO ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
(?hone, No. (860)528-0131
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Pe, Mit No. 7127 Town of South Windsor, CT
Permit Date 03/24/2000 Drain Laver Permit
Expiration bate 04/23/2000
Descr, ip: CK 22695 PERMIT FEE
Applicant Location
Name H. W. LEVACK CO. 61065 EDGEWOOD DRIVE
Addr. 49 MASCOLO ROAD w.e ,WILSON DONNA M
SOUTH WINDSOR CT ; $Q `4
Phone No. (860 )528-0131
The Drai n Layer asifr}s�l ihv s per h4 i t has ,=a v�7 d 1. cense issued by the
state and hereby agr8e 1;c � ` i;"+e' terms;, and �C5idltions set forth in the
attached 'Conditions' . 1 crk sha1,] �n a cbr0" 0 with Town of South
Windsor standards, all -'OSH + t�et U#t"f 111�Y1 y and th$ ettached conditions .
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Issued ByFfZNP
Date Inspected 3�_-9 or-, _�� L sPe _ BY --
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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 $25.00
Location of proposed work:_ �� G� Lot *
Street No. Street Name
Premises owned
Name of Firm: �,,�✓ �1 �"i,� Phone: z/� 1�
Address of Firm: �"�
TYPE OF WORK:
Lay House Drain pair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with G"4 �� �' ,h 72
Existing Water Supply: Public Water L� Well
Proposed Start Date .3 ` 2F 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 A` �� G����� the holder of Drain
Layer's License No.f . Only holders of P1 or P7 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. ao 2 !I and/or-ConnDOT Permit No. �
CBYD No. Dz' _•
Signed: Print Name:
Licensed D in Layer
Date: �-
Standard Forms\Permlts\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
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DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET 40 �b
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUP VISO (PRINT)
STREET ADDRESS SIGNAtUlfE
DATE
TOWN STATE ZIP INSPE D 6 TOWN
DATE
TELEPHONE.NUMBER
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