HomeMy WebLinkAboutDrain Layers Permit 2422 Ellington Road i
TOWN OF SOUTH WINDSOR INSPECTION REPORT {
l'
Permit No. 7763 Contxae, orYCALDk3 ,,.CONSTRUCTION
Location i4ti Y Ad3res ' F�80 REST kh.,
Type Work RPR SAN LAT cl:: <" f>
A "F Si1� I.4D. C'P.,= 06093
Phor�s N� x�8 ?)242 '3€3a7
.vim V.
D In ate �.:Ne
eded eede d
Time Insp Needed •s^• m : I '
Insp ".»
ected By ` ,
Work in Progress —
x-- }
u
,
f ".
.. .:
�..
I
I
i
I
1
in
Permit No. 7763 Town of South Windsor, CT
Permit Date 07/02/2004 �" '" ""`"'^ :<
� Drain Layer Permit
Expiration Date 08/01/2004 " g.F;g F''<: ry^ R�<.., x`3:•
Descrip: RELOCATE BUILDING SF:K13R.- LiD
/ A.
Applicant N v: h n Y y:. hQ
Name CALDEIRA CONSTRUC III:(�I ' .i; i .=s "s«> c: :. L .JIIExTfl27.''aROD
Addr. 580 FOREST RD ( fj IENKO0? :XZ -V UL L>. KATHLEEN M
�7 y.
y+'�`• c ^' �` � `�fi�y�x Y'=§��'� of ��i j a:k
WEST SUFFIELD C 0603 "" • � ,*" '
W
Phone No. (860)242-7q>1Teoz/
The Drain Layer sign' s' `ed b
d`: ��p =;P hss f:sau y the
state and hereby ag ad r-66 .X: he ''t r .`s.*.. "Y' '%>t e ms aria coYY 'i tin " .
:. r.: . to><:: ao r. h i n the
attached Conditions , All`wc��` k<.sri4 'f .'F °' ` ire'';"fif d. th Tosdn of South
f�. ._ ...: . ...: ..:.: r
Windsor standards, al - OSIAx` `}zirn ''
�T . ;�az![:. e. at, d` i�gci';<coridit ions.
a•x
Issu
ed B
---------------
By
Date Inspected --------------------- I'nsS'L`d`C' 'c
--. -���
�• 776'-?
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: ?y;2-� LL'iv.�Tcvr/ �o
Street
No. Street Name '
Premises Owned by: &1-
Name of�irm:�a� ,��`ra, �od1�4Pu4-J oXW.,Phone: 8 -
Address.of Firm: & SO
'TYPE OF WORK:
Lay House Drain; Repair House Drain
Lay Main _____; Lay Laterar for Commerdai/Industrial
Building_______,._.of acres
Connection will be made with LP e.3s
Existing Water Supply: Public Water . Well
Proposed Start Date - Estimated time for completion
ALL WORK-TO BE IN ACCORDANCE WITHTOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUfREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit-is to be issued to J� o ` the holder of Drain
Layer's License No.
- � � . Only.holders of P-1, P=7 or V11-9 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. n/�),VQ77
Signed: V int Naive: <Jas��, t �d �[1
'censed Drain Layer
Date:
Standard Forms\ itsWPLIMONTOR DRAIN LAYERS PERmrr.doe
TOWN OF SOUTH WINDSOR
I SANITARY �--.SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS C �o
STREET
SUBDIVISION:
NORTH ARROW
k
!
i
_L. 1 4 1 � k
if
i
1 1 I
i 1 4 i
1 S:
1
_ s
i
TVi
j t
CONTRACTOR (PRINT) NAME OF CONT CTOR'S SUPERVISOR (PRINT
,5a o � s-4 12c/ YZKO-
STREET ADDRESS q S TUR
Jy�FCr r P(U P'. L��o I� I2IvorDATE
TOWN STATE ZIP
ZIP INSPECTED BY TOWN
e C ��_ DATE
TELEPHONE NUMBED
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER