HomeMy WebLinkAboutDrain Layers Permit 96 Farm Brook Drive Permit No. 6817 Contractor YANCEY
Location 0096 FARM BROOK LANE Address 27 R COMMERCE STREET
Type Wofk NEW SAN LAT GLASTONBURY CT 06033
Phone No. (860)633-0423
Date Insp Needed �' �'��� Date Irtsp. �-3-99
Time Insp Needed � � Tlh�e rnrsp.
Inspected By
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Permit No. 6817 Town of South Windsor, CT
Expiration Date 06/28/1998 jyr�.�,/ �8►/ �' �„ ,l���� �✓wafer. fig
Descrip:
Applicant Location
Name YANCEY Addr . 0096 FARM BROOK LANE
Addr. 27 R COMMERCE STREET Owner LACAVA CONSTRUCTION COMPANY
GLASTONBURY CT 06033
Phone No. (860 )633-0423
The Drain Layer assign4d th7`s perm7,t has vaid, 1icense issued by the
state and hereby agrees to tall ,the toms.,and, oimd,,Aiohs set forth in the
attached 'Conditions ' .',' Ali= War .!shl1 bef.;in ac.Codanca with Town of South
Windsor standards , all '4SHb r"�Gta i r® erti;s, anti t §tGached conditions.
Issued BY �. T i1+
Date Inspected lU 3 -�� nspeoted B�! �
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APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WRYDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work Lot #
Street No. Street Name
Premises owned by: ,&q«e-,o?, e-,—
Name of Firm: r ;} _ Phone: Y
Address of Firm: �2;7,00jj�"
TYPE OF WORK: e
Lay House Drain Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 2�f
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 ea (:e - en� ' r 7 the holder of Drain
layer's License No. � Only holders of PI(T7 & W9 licenses will be
issued a permit. Permit will expire thirty (301 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.
Signed: Print Name
Licensed Drain Layer
Date:
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS : .4 zx
STREET
SUBDIVISION: x4rjn.,4�-
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CONTRACT (PRINT) NAME OF CONTRACTOR'S UP OR (PRINT)
STREET ADDRESS SIGNATU //
r r0 .3 DATE
TOWN STATE ZIP INSPECTED BY TOWN
W o - 6-0-v k .3 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER