HomeMy WebLinkAboutDrain Layers Permit 1430 Ellington Road (2) i
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+► TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7480 Contractor S.J . HOFFMAN CONSTRUCTION LLC
Location ' ` " ,•' Address 77 HOFFMAN ROAD
Type Work R A` ELLINGTON CT 06029
e No. (860)872-8375
Date Insp Needed I 2 OZ
Time Insp Needed
Inspected By
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P,ermi t No. *Q Town of South Windsor, CT
Permit-Date 08/06/2002 Drain Layer Permit
Expiration Date 09/05/2002
.Descrip:
Applicant Location
Name B.J . HOFFMAN CONSTRU df 30 ELLINGTON ROAD
Addr. 77 HOFFMAN ROAD YEN NGAN THANH &
ELLINGTON
Phone No. (860)872-837
The Drain Layer i ha 1V . license issued by the
state and hereby ag lr an �t1 ns set forth in the
attached 'Condition in ce with Town of South
Windsor standards, 1 re tacked conditions.
Issued By •
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�te 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 $25.00
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. Location of proposed work: Lot #�� 1� °i
Street No. St eet Name
Premises owned by: As 7�q A 'eh
Name of Firm: y(!? f o �7` h'� 4 t C Phone:
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Address of Firm:
TYPE OF WORK: /
Lay House Drain ; Repair House Drain ✓ ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
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Connection will be made with 'TIP n 3j
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 ST #0 � 4 a 4. C oh j L 4e holder of Drain
Layer's License No. a7 ir a.?> 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: Q7-C j e 4 ('v
Licen ed Drain Layer
Date:
Standard Forms\Permits\APPLICA7n0N FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 8 / ' 0 D
BUILDING ADDRESS
STREET :
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATURE
0 fit G Ul? /q� c DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
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