HomeMy WebLinkAboutDrain Layers Permit 111 Farm Brook Lane Permit N(,, 6767 Town of . -g,Vth Windsor, CT
Permit Date 03/03/ 1998 Urairr L r- i`Permit
Expiration Date 04/02/ 1995
Descr i p :
Applicant Location
Name YANCEY Addr 0111 FARM BROOK LANE G ;
Addr . 27 R COMMERCE STREET Lw +~ ACq�iA r�ONSTRUCTION COMPANY
GLASTONBURY CT .:0603 `
Phone No. ( 860 )6:33-0423
The Drain Layer assigned thl.-, permit h s a va1fd ticense issued by the
state and hereby agrees to' all theeris :4nd c0dit)ons set forth in the
attached 'Conditions .,', A 1 I � Wo"r,k shy i 11 'ba in 'acoo,rdanCe with Town of South
Windsor standards, al1 ` OSHA requirements, and tom, att6ched conditions .
Issued By �,.. _. -- - T1te •-' _
Date Inspected _' 111�18,. Inspected(by _-------- -`� QJ A.____ i5
TOWN OF SOUTH WINUSOR SN6PECTIuN REPOR-!"
Permit No. 6767 Contractor YANCEY
Location 01 1 1 FARM BROOIK LANE Address 27 R COMMERCE STREET
Type Wovk NEW SAN LAT
� �r �o GLASTONBURY CT 06033
Phone No. (860)633-042:3
Date Insp Needed Date Insp• _ __-__--
Time Insp Needed Time ` Inep, yr=
Inspected By
Work i n Progress 1 __ AFL,
I n pu �5- �2 - Date _
APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WIIITDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location o,f proposed work a =l: vJ df r r ', 4 Lot #
Street No. Street Name
Premises owned by: !14 4111
Name of Firm: ., G:c gy -, a Phone: � >'..� 0;
Address of Firm: 131 �✓" ,,,�� t �` '� i O �'
TYPE OF WORK.
Lay House Drain Repair House Drain ;
Lay Main ; Lay Lateral for CommerciaVIndustrial
Building of acres _
Connection will be made with,5� .� �If,"
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 if -/ ,IY r the holder of Drain
layer's License No. Only holders of Pl P7 8a 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. 0?/0 OL %� .
Signed: is '-' Print Name e r 'I�Fal
�c` C
Licensed Drain Layer
Date: -�/ �y
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: T ��
BUILDING ADDRESS /o
STREET ®a 4 a, �e.
+ SUBDIVISION:
NORTH ARROW
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CONTRACTOR/(PRINT) NAME OF CO TRACTOR'S SUPE R (PRINT)
STREET ADDRESS SIGNAT E
u, DATE
TOWN STATE ZIP INSPECTE TOWN
O P�-el& DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER