HomeMy WebLinkAboutDrain Layers Permit 16 Farm Brook Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6643 on-t.r�actor YANCEY
Location 0016 FARM BROOK LANE Adc�res's , 27 R COMMERCE STREET
Type Work NEW SAN LAT.
,nva GLASTONBURY CT 06033
;P,-h6 0 No ($60)633-0423
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Permit No. 6643 Town of South Windsor, CT
Permit Date 07/10/1997 Drain Layer Permit
Expiration Date 08/09/1997
Descrip: CONN FEE PAID #4756
Applicant Location
Name YANCEYAidr. Qt?1"i FARM BROOK LANE
Addr . 27 R COMMERCE STREET 4t Olkner'LACAVA CONSTRUCTION COMPANY
GLASTONBURY CT Oe.03,3 jr
Phone No. (860 )633-0423
The Drain Layer assigned `this permit :his a wal'id l'i-cense issued by the
state and hereby agrees to, the terms` and oo�dit`16 s set forth in the
attached 'Conditions' . A11 'wiork shai1 ,be in-:Agco.�da ce' with Town of South
Windsor sta6dartlds, all OSHA `'requ ire ments and the attached conditions.
Issued By --
t
Date Inspected -----_. 17 Inspected By
APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH W11VDSOR
F PUBLIC WORKS DEPARTMENT G�
R TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WWDSOR, CT
FEE$25.00
Location of proposed work: 4�Yo o l Lot # /
Street No. Street Name
Premises owned by: GAUJ9 �»v
Name of Firm: a Phone:
Address of Firm: ct��� �a�,-►,�Grcc, , "f �s e��r�ry �?�
TYPE OF WORK:
Lay House Drain_�I°_; Repair House Drain ;
Lay Main ; Lay Lateral for CommerciaVIndustrial
Building of acres
Connection will be made with 41,1C
Proposed Start Date f/ 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 Q oee 1,-7 the holder of Drain
layer's License No. ®Da pd'f/ Only holders of Pl, 7 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. ,974 98 0 4a2 3.
Signed: Print Name el�co'qC
Licensed Drain yer
Date:- � /o -----— --
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