HomeMy WebLinkAboutDrain Layers Permit 871 Ellington Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7997 Co.atTa:.r,tor u, OIET,T'E,:SILVESTER & SONS
Location 0.871 ELLINGTON%ROAD .C�ERRy. ST37EET
Type Work NEW SAN LAT ORD:-.CT 06108
Phone No (8 ) 89 3466
Date Ins Needed
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Inspected By
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Permit No. 7997 Town of South Windsor, CT
Permit Date 11/15/2005
Drain Layer Permit i
Expiration Date 12/15/2005
Descrip:
Applicant
LCrca to on
j.,
Name VIOLETTE SILVESTER & $OriJF t871 E� xZNGTON: ROAD
Addr. 65 CHERRY STRE$T
Q1a�er ANDERSON I�QGER: i DONNA S
EAST HARTFORD :. CT 06108:.., "
Phone No. (860)289-3466
The Drain Layer assigned this pegm�t iia ualid 3iCense: i`s 'ued by the
state and hereby agrees.:ta all'.the terms end conditions 'set fgrth in the
attached 'Conditions' All work shad }ae in .acCcrrdar�ce wits' Town of South
Windsor standards, all OSHA requir men , 'and ttie a tac$e 'conditions.
Issued By
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Date Inspected ....... Inspected By �s ���
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: 4d
Street No. Lot #
treat Name
Premises owned by: c,
Name of Firm:_ tole- ��—JAPhone: ;2d9j X4q
Address.of Firm: �S- C��t� -
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 -os f d v e_
Layer's License No. >� the holder of Drain
. Only holders of P-1, P-7 or W.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 ConnDQT Permit No.
-CBYD No. 006 .3
j
Signed: z� Print Name: )Os --
icensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
- R5K-KELLEU1NC.
• Developers 1744
• Builders Ellington Road
• Property South Windsor, CT 06074
Managers Tel:860-644-8761 /644-8140
Email: RSKSW@AOL.COM
Fax:860.644-5650
Ct. Registration#278
RECEIPT
Received From: Roger Anderson
Address: 871 Ellington Road
South Windsor CT 06074
Amount: Six Thousand Five Hundred Fifty-Two Dollars ($6 552 00)
For: Connection to the Sanitary Sewer Main on Ellington Road
By
RSK llco, Inc.
Date
We Build Our Reputation
RSK-KELLCO, INC.1744 Ellington Road Invoice
South Windsor, CT 06074 Number: 1046
Tel: 860-644-8761
Fax: 860-644-5650 Date: November 08,2005
Bill To: Ship To:
Roger Anderson Roger Anderson
871 Ellington Road 871 Ellington Road
South Windsor, CT 06074 South Windsor, CT 06074
PO Number Terms Customer# Ship
Description Quantity Price Each Tax Amount
For Connector to Sanitary Sewer Main
on Ellington Road
Base Fee: 1,888.00
Lateral Fee: 944.00
Frontage Fee: 120 ft. @ $31.00/ft. 3,720.00
Please make your check payable to "RSK-Kellco, Inc."
Sub-Total $6,552.00
State Tax 6.00%on 0.00 0.00
Total $6,552.00
0-30 days 31 -60 days 61 -90 days > 90 days Total
$6, 552.00 $0.00 $0.00 $0.00 $6, 552.00
TOWN ' -OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF ICONT CTOR'S SUPERVISOR (PRINT)
11116 t r
STREET
ADDRESS SWTUA
``/ l. DATE
TOWN -ATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER