HomeMy WebLinkAboutDrain Layers Permit 2680 Ellington Road TOWN OF SOU
TH WINDSOR INSPECTION REPORT
Permit No. 8071 Cont x_a>etor HOME WN—RR,
Location A. dress-4; <'= SAME'';:A °ABOVE..
Type Work SAME A ` A33V$
53PUTH ➢l-NDSOk CT 0,6074
Phone,-No ¢• v0)opa oao:o
Date Insp Needed `
Time Insp Needed Pi.me Ipy�1
Inspected By
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Permit No. 8071 Town of South Windsor, CT
Permit Date 07/13/2006 Drain Layer Permit
Expiration Date 08/12/2006
Descrip: HOMEOWNER DONALD CHII:4f5RE `",
Applicant
e50 :t,lon
Name HOMEOWNER ds r .2680 ELI I44TOI7 ROAD
Addr. SAME AS ABOVE
Nvper BOGGIO-MICHP;EL L
SAME AS ABOVE
SOUTH WINDSOR fQi._66014
Phone No. (000)000-0000. ,.'
X.
The Drain Layer asssgnd tki s gent $�s �x vim]3d lficense issued by the
state and hereby agrees to W. the terms `andns,.:sAt.:. forlh in the
attached 'Conditions--,:..,;::, i':>`GV
o ctan e wfth TbOn of South
Windsor standards, all OSHA` j.uiremnts ande athe ,,.coxsditions.
CIssued BY /
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:
Date Inspected
Tris mete
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 proposeg,work: Gd'd
` # .
Street No. Street Name Lot
Premises owned by: .r
Name of Firm: -
Phone:
Add
ress.of Firm:
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 -2:;(�-r—c.,/� Estimated time for completion _J (.
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
Layer's License No. the holder of Drain
will be issued,a • Only holders of P-11 P-7.or W 9 licenses
permit. PERMIT WILL, EXPIRE THIRTY(30),DAYS AFTERDATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms
-and conditions.set forth in the permit and attached thereto.
Town Street Excavation Permit No. Applicant has received
and/or ConnDOT Permit No.
e
CBYD No.
Print Name:
----Ucensed_Dr-ain-Layer-
/ _G
Standard FArms\PermitS\APPLICM0N FOR DRAIN LAYERS PERMIT.d0C
- TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE. OF 'CONSTRUCTION: 7Z .11 Zo (�
BUILDING ADDRESS
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME 0 CO RACTOR' SOR (PRINT)
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STREET ADDRfSS SIG
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5', UJ r� SQ u- yZ, 7 /f3 C�
DATE
TOWN STATE ZIP INSPECTED BY TOWN
C 2 o y DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER