HomeMy WebLinkAboutDrain Layers Permit 585 Felt Road `r TOWN OF SOUTH WINDSOR INSPECTION REPORT j
Permit No. 7591 Contractor DEBRIKO/BRIAN KOCHER D/B/A
Location I Igo' -%� Address 50 ELM STREET
Type Work N T VERNON CT 06066
e No. (860)870-9746
Date Insp Needed 10 n /0 7- e ` -
Time Insp Needed s3 M
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Inspected By
Work in Progress
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Perm*-*'nA 7591 Town of South Windsor, CT
Permit Date 10/18/2002 Drain Layer Permit
Expiration Date- 11/17/2002
Descrip: NEW SAN LATERAL
Applicant' Location
Name DEBRIKO/BRIAN KOCHER A/ FELT RD
Addr. 50 ELM STREET r%
VERNON C
Phone No. (860)870-974
The Drain Layer i has icense issued by the
state and hereby ag e i t an �ti ns set forth in the
attached 'Condition n e with Town of South
Windsor standards, a IS '�C ached conditions.
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Issued By V
Date Inspected SOM41 By
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: G Lot #
Street No. Street Name
Premises owned by, (6k,ld
Name of Firm: > -C ` ` -C 0 Phone .-d
Address of Firm: 22
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TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
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Connection will be made with -35 -
Existing Water Supply: Public Water Well
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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 V"'- a I the holder of Drain
Layer's License No. 2-2 ;2 � . Only holders of P1 or P7 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.
CBYD No. �O �I T---
5 -
Signed. Print Name: �h ���
Licensed brain Layer
Date:
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Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
µ TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: /o/a3/0
BUILDING ADDRESS `
STREET
SUBDIVISION:
NORTH ARROW
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STREET ADDjDRES / SIGNATURE
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TOWN STATE ZIP INSPECTED BY TOWN
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TELEPHONE NUMBER
WHITE - TOWN c / PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER