HomeMy WebLinkAboutDrain Layers Permit 118 Farmstead DriveiTOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7037 Contractor EASTERN WATERPROOFING
Location 0118 FARMSTEAD DRIVE Address P.O. BOX 504
Type Work NEW SAN LAT
SOUTH WINDSOR CT 06074
Phone No. (860)875-6646
Date Insp Needed
/ "�--� DateJInsp: ! I
Time Insp Needed 7 Time Insp
T —
Inspected By
4
eE
Work in Progress Z�
Input � �r Date
Permi�4No. 7037 Town of South Windsor, CT
Pet e-.pate 08/18/1999 Drain Layer Permit
Expirtjation Date 09/17/1999
Desc r i.;p:
I
Applicant Location I
Name EASTERN WATERPROOFING Addr.` 0118 FARMSTEAD DRIVE
Addr. P.O. BOX 504 ,Owner ILQVICI MARC D+IRINA S SURV
SOUTH WINDSOR CT 064
Phone No. (860)875-6646 I
The Drain Layer a sngrttd= th a p��xt�f�t ;h ►s 4 val. id °1: cense issued by the
state and hereby agrees to the :teat and os�nCii ti ons set forth in the
attached 'Conditions } ;WQ k shady ,in acpjgr,ftnc0 with Town of South
Windsor standards, a t.1 .. q f ra"ntnt and this, ittsched conditions.
t
Issued By �� 'i£tl® s �.
t
z� r
e >
Date Inspected hspa3cto:d °8y
�— r-- -
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work:-/ S'l-ecf-c'l Lot #
Street No. Street Name
Premises owned by: Mut
Name of Firm: �a S Xv� -- ft cv Phone:
Address of Firm;Ro 50 < w �\'r\&s a C7—
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be .made with �, f'
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 4 the holder of Drain
Layer's License No. Ooaoeb3,5 Only holders of P1, 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 Name:
Licensed rain Layer
Date:
Standard Forms\Permits\APPLICAMN FOR DRAIN LAYERS PERMrr.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD . LOCATION
DATE OF CONSTRUCTION: el ( ci q
BUILDING ADDRESS
STREET
SUBDIVISION:
NORTH ARROW
44. _ t
Ajk
{ ! f
, 3
i .
CONTRACTOR (PRINT). NAME OF CONTRACT Rt SUPERVISOR (PRINT)
Vwry �
STREET ADDRESS p SIGNAT
� '(-�--_ C� DATE
TOWN STATE ZIP INSPECTED TOWN
DATE
`E"-rPHONE NUMBER
f fE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER