HomeMy WebLinkAboutDrain Layers Permit 31 Elizabeth Street Permit No. 7253 Town of South Windsor, CT
Permit Date 03/27/2001 Drain Layer Permit
Expiration Date 04/26/2001
Descrip:
Applicant Location
Name SKIPS SEPTIC 'Abdr - 031 ELIZABETH STREET
Addr. 27 MUDDY BROOK ROAD Awref WARD JOSEPH A '+ JENNIFER J
ELL.INGTON CT O50*
Phone No. (860)875-2332
The Drain Layer as`s i fined tf i=s psr, ii t; has a v,4l;i tl license issued by the
state and hereby agre,p 1 a �° tk .' t� ms-andv €I'itolns set forth in the
attached 'Conditions A t,lt v�Qrk shag be, i n a' m-r�dance with Town of South
Windsor standards, al}l f3Sl A requir men s; send the attached conditions.
Issued By
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APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH VIMSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AV JffM
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: 3 f - - 51' Lot.#
Street No. Street Name
Premises owned by: �e r_ LU FIX
Name of Firm: �S kfrS SCV7'fc. Phone: 875-2 3 311_
Address of Firm: 27 tuaPp y Bx6ok lZ' Ekk_1467V tJ
TYPE OF WORK.
Lay House Drain ; -Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Proposed Start Date 9 0! Estimated time for completion 3 30 o f
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 -7jr4 hALke9— the holder of Drain
layer's License No. o2Q'77 Z f . Only holders of P1, P7 & W9 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.
Signed: APrint Name �'1 tv,4t ck y j 1,-
Licensed Drain La er
Date: � z 2 f
C�y� 200. 1 fZ O l W(o
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS 3 ) El,k Z Pr T 4 ST.
STREET
-I- SUBDIVISION:
NORTH ARROW
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�rPS 51VTIC. TANS zfl?UiC� ANC I CRA-i L Qq-c-',
CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATURE
Sou-T H w ®5®r CT ® of � vQATE
TOWN STATE ZIP INSPECTED BY TOWN
cZ(o `3.3 DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER
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