HomeMy WebLinkAboutDrain Layers Permit 2163 Ellington Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7627 Cori.. C,Q;VEN. g0N:S:TRUCTION CO.
Location 27.63 MINGTOt ROAD . Addres::s A:O. :BOX 427 ':<
Type Work NEW SAN LAT COVENTRY TrI.D6.2148
Phone .No (8fjX).282 0526
Date Insp Needed _ - ate-I
Time Insp Needed dime Xri�i p�
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Inspected By
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Permit No. 7627 Town of South Windsor, CT
Permit Date 05/05/2003 Drain Layer Permit
Expiration Date 06/04/2003
Descrip: CK 2063 $60.00 CK 206q $35 0,4:
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Applicant - Lcaton
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Name COVEN CONSTRUCTION C LLINb:TON..ROAD
Addr.. P.O. BOX 427
O.w;ner LA3IZAUATE A.
COVENTRY .CT: 0623$
Phone No. (860)282 0526
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The Drain Layer ass%gn�d this permit 1sS xral2d 1: cease issued by the
state and hereby agrees.,,::.to all' the terms . pd conditions set forth in the
attached 'Conditions A11 Work h Y`1 lxe: n accdrt3ance with'Town of South
Windsor standards, aft.-OSHA r d .the attached 'conditions.
Issued BY Title
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Date Inspected _ � _� ---- Inspected Inspected 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 $60.00
2 / 63
Location of proposed work: �C��i�� �a� Lot #
Street No. Street Name
Premises owned by:
Name of Firm: c Nv U l� � � S� l v� l w� Phone: j Yo�
Address of Firm: U ��� d-�j L,ti /Z e-� 06d yg
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with y P
Existing Water Supply: Public Water �' Well
Proposed Start Date1ACORDANCE
5 0' Estimated time for completion 1 U
ALL WORK TO BE IN WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to _ M LL_)i21_1j L the holder of Drain
Layer's License No. o Ci R6 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. and/or ConnDOT Permit No.
CBYD No.
Signed: Print Name:
\ Licens D in yer
IC
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, Date:
Standard Forms\ ermits\AP CATION FOR DRAIN LAYERS PERMIT.doc
V TOWN OF SOUTH WINDSOR
SANITARY . SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS 5( ( 63
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTO 'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
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TELEPHONE NUMBER
HITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER