HomeMy WebLinkAboutDrain Layers Permit 5 Farm Brook Lane TOWN OF SOUTH WINDS )R INSPEC110N REPOkT
Permit. No. 6783 Contractor YANCEY
Location 0005 FARM BROOK t.ANE Address 27 R COMMFRCE STREET"
Type Work NEW SAN LAT GLASTONBURY CT 06013'3
Photie"` 1'io. (860 )633-•042
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Date Insp Needed
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Time Insp Needed risp,
Inspected By
Work in Progress
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Ii1 ,u : � - - Bates
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Permit. No . b r 30' i"own of South Windsor , CT
Permit Bate 04/0 f / i'.a'.�t; Drain t_ayer Permit
Expirati(;n Date 05/07/ i99a
Descr i p : PRORATE- PAIC)
Applicant Location
Name YAN.,E1( Addr . O005 FARM BROCK LAME
Addr . 27 R COMMERCE STREET (Dwner ' LACAVA COr1;�TRUt TTON COMPANY
GLASTONBURY CT 0604 i ,
Phone No. (860 )63 :--0423
The Drain Layer assigned this permit ha.s v 1j.d fitense issued by the
state and hereby agrees tee_"��.,fi tCte tq' r. s .and ccgnditict�r>s set -Forth in the
attacried ' Conditions ' : ;i I" work shall -�iae' 4n accorda,nc<e.' with Town of South
Wind nor standards , a i i C7�HA 'r'egtli remFn�s arid #.ham ati �c,lied c�nd i t i one .
Issued BY ' �� �' fi1 � �{ `� :f =
Date Inspected Qz _ i T 1nspf—c,ted key
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APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WIlVDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work 1 Lot # f
Street No. Street Name
Premises owned by:
Name of Firm: n Phone: f >; ,j f,/z
Address of Firm:
TYPE OF WORK:
Lay House Drain Repair House Drain ;
Lay Main ; Lay Lateral for CommerciaVIndus trial
Building of acres
Connection will be made with `4 m:_
Proposed Start Date VAQ 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 Cox the holder of Drain
layer's License No. a Only holders of Pl, P7 & W9 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.
Signed: Print Nameci�� %
Licensed Dr Layer
Date:
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS ��
STREET
SUBDIVISION: jg=c,_�,n 6/1 d,
NORTH ARROW
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CONTRACTO (PRINT) NAME OF CONTRACTORS SUPE VI PRINT)
Pto. ®�
STREET ADDRESS SIGNATdRf
�2/,n,. c — _,,f . 6 DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER