HomeMy WebLinkAboutDrain Layers Permit 36 Farm Brook Lane r i
TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 6488 Contractor YANCEY
Location 0036 FARM BROOK LANE Address 27 R COMMERCE STREET
Type Work NEW SAN LAT GLASTONBURY CT 06033
Phone No. (860)633-0423
Date Insp Needed mate I nsp
Time Insp Needed E� � T"�mrlp ,��.' > -- 'v.�s�s`
Inspected By —
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Permit No. 6.488 Town of South Windsor, CT
Permit date 10/08/1996 Drain Layer Permit
Elpiration Date 11/07/1996
Descrip :
Applicant Location
Name YANCEY Addr. :0036 FARM BROOK LANE
Addr. 27 R COMMERCE STREET Owner LACAVA CONSTRUCTION COMPANY
GLASTONBURY CT 46033
Phone No. (860)633--0423
The Drain Layer asstgned ,th7s permit has v J, d`., li:cense issued by the
state and hereby agrees tee a 1 l` ��the tewt &� end con `I: iloos set forth in the
attached 'Conditions' A J wtd-rk sha,1 sbe= -fn accor'dance� wi th Town of South
Windsor standards, all OSHA r. equiremerite and the',,attached conditions.
Issued By � . ,�.r� ,e ��.u� � 8 ,�'�'� •�.rail-, �yr�..�t-r _
Date Inspected _- .� �s��9� tn
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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:
l
Address of Fir -
TYPE OF WORK:
Lay House Drain x Repair House Drain ;
Lay Main _ ; Lay Lateral for CommerciaVIndustrial
Building of acres
Connection will be made with
Proposed Start Date1019 e6 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 l y¢� �� �► the holder of Drain
layer's License No. Only holders of P , 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.
Signed: Print Name , &z ,a`'
Licensed Draif&yer
r
�Date0 �
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS OR LOT N' :
STREET:
SUBDIVISION:
NH STATION : +
NORTH ARROW INVERT ELEV:
T 17 TIE
v�
HOUSE �G 9 '__ LATERAL LATERAL HOUSE
CONNECTION STUB STUB CONNECTION
_FT. ? FT.
BUILDING IN LEV. INV.ELEV. INV. ELEV. INV. ELEV. BUILDING
U.
(IF EXIST.) (IF EXIST.)
6)-of
TIE TIE
C�
�'tine�e bJ� NH STATION : +
INV.EERRT ELEV:
CONTRAC OR (PRINT) NAME OF CONTRA 'S SUPERVISOR(PRINT)
STREET ADDRESS SIGNATURE7 DATE
C 03,
TOWN STATE ZIP INSPECTED BY TOWN DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW -CONSULTING ENGINEER/DEVELOPER