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HomeMy WebLinkAboutDrain Layers Permit 6 Farm Brook Lane Permit+ N©.- b765 Town of South Windsor , CT Permit Dat6 0:3/Cj3/ 1998 Drain Layer Permit Expiraation Date 04/02/1998 Descr_ ip. ` Applicant Location Name YANCEY Addr. 0006 FARM BROOK LANE z�% = Z. Addr . 27 R COMMERCE STREET .;vWrte,f _ LACAVA CONSTRUCTION COMPANY GLASTONBURY CT 060,�3 : E Phone No. (. 860 )63.°3-()423 The Drain Layer ass i ghied th. s per?m'it -has a ya1'A'd, } i":tense issued by the state and hereby agrees to; a1.T. th6 'terme and ron4t i'or'U set forth in the attached 'Con d i t 14� #,��;;ai '60'a *1-5%i th Town of South Windsor standards , all OSHA re,quiregiments,l and the-attached conditions . Issued E3y T`ila - - _ }_ Date Inspected ------ �� �g-- _� lrvspeeted 'BY 1 OWN OF SUU i H WfNDSok INSPECTION kEPORT Permit No. 6765 Contractor YANCEY Location 0006 FARM BROOK LANi=Ly ,Z, Address 27 R COMMERCE STREET Type Work NEW SAN LAT GLASTONBURY CT 0603; Phone No. ( .550 )6':3 -0423 Date Insp Needed Date Insp Time Insp Needed �_ a Inspected By r . Work in Progress ----— ----- --- -- - - -- -- -=- -:= =-- — ° ' hrlput Date = - — ti APPLICATION FOR DRAIN LAYERS PERMIT TOWN OF SOUTH WINDSOR 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: Name of Firm: Phone: Address of Firm: TYPE OF WORK: Lay House Drain 61 Repair House Drain ; Lay Main Lay Lateral for Commercial/Industrial Building of acres Connection will be made with x5' ,o � r Proposed Start Date-Zf07Estimated 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 the holder of Drain layer's License No. -� 6,P,, 7. On y holders of Pl,� 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: � j, Print Name 16. , 1 Licensed Drain Layer Date: - TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: 's /i e BUILDING ADDRESS C;:?yZ STREET SUBDIVISION: NORTH ARROW 1 F t i I : • t i i f r L f I s r , i � t ! s ' i — t � t I i i i '— i•'— i- i 9 —' i s : t -- i ! { } a t , B CONTRACT (PRI NAME OF CONT C TOR'S SUP VI (PRINT) /"ea �/ STREET ADDRESS SIG UR Q� ial:,lDATE o f7��� 3 3 Iz 9d TOWN STATE ZIP INSPEC30 BY TOWN DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER