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HomeMy WebLinkAboutDrain Layers Permit 125 Ellington Road TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 7488 Contractor BOURGEOIS & SHAW, INC. Location Address 132 FIRETOWN RD Type Work RPR SAN LAT SIMSBURY CT 06070 ne No. (860)658-0448 Date Insp Needed I Time Insp Needed Inspected By Work in Progress ►4` a Csv� A-S - 3'�al�� l'�U�- Date - �a- P ritNo. 7488 Town of South Windsor, CT P`grm�-t Date 08/15/2002 Drain Layer Permit Exp .r--ation Date 09/14/2002 Des-e r i p Q.$T OUTPUT Applicant Location Name BOURGEOIS & SHAW, I .-K 25 ELLINGTON ROAD Addr. 132 FIRETOWN RD S REALTY CONNECTICUT INC SIMSBURY T Phone No. (860)658=04 8 The Drain Lay®r h ha license issued by the state and hereby , 1 an It ons set forth in the attached 'Condittio ? in ce with Town of South Windsor standardfs, r tached conditions. Issued By ` a B c d Date Inspected Y i 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: �ih c� Lot # Street No., treet Name Premises owned by: \ ©� Name of Firm: . Phone: i Address of Firm: t rA�h 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 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 but the holder of Drain Layer's License No. c�^7 Only h rs 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. cP.00 a. l S Prin Name: �Valart;Slgned: t .— Licensed rain Layer( Date: Standard FormsTermits\APPLICATION FOR DRAIN LAYERS PERMrr.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL , FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS STREET : SUBDIVISION: NORTH ARROW ....... ._ _ __ _ ___ i { _ ! -It- __ ._. _ __t..__ . _ - i r i , { i t I , _I. { ! { t 1 , j ' { i F. f F f t CONTRACTOR (PRINT) / NAME OF 0 CTOR'S SUPERVISOR (P 7� STREET ADDRESS SIGNA R C_ A.'C a:,- rY!/'::F DATE TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER