HomeMy WebLinkAboutDrain Layers Permit 207 Buckland Road " TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8130 Corr,t;-f*actow'HPJ`µQONS`RUCTION CO.
Location 0207 BUCKLAND ROAD ,.Yc7c} 522°<<S'AIN'ON.6BkQ.QK STREET
Type Work NEW SAN LAT CTd6 '4'3 <4'YP :"�... '�.�,t;:'fx:��3kkB:Y.. 5
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Permit No. 8130 Town of South Windsor, CT j
Permit Date 01/03/2007 "" "' ""«> Drain Layer Permit i
Expiration Date 02/02/2007
Descri HOUSE CONNECTION AT 'p: 2ff 7 BI.. KEMND'RPi.
Applicant <:.
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Name HPJ CONSTRUCTION
Addr. 522 SALMON BROOK 'STRBE "`": .;.::?F Ofua'eLUU DIT3'.:.I3-pAIG` &
GRANBY
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° ' Is Drain Layer < i . ? .� .F
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state and hereby agre4/ a::: 1 heer'm <'arid" coT' t. an. :yt:<>:forh in the
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attached 'Conditions'`•:,. ;-'All 'uiO'ric;;`. 1a1 ;<`?`'< ,� T
r2; p! .daiz.e::e ith bah of South
Windsor standards, al OSHA ` eq}xir`'e 3ts;:><a.,.c'.' att; `clied2:.:Gor'ditions.
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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:- Z07 B(Jc n(L"`N S Lot #
Street No. Street Name
Premises owned by: Street
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Name of Firm 'Z/ Phone: %o-6L>>'?2(S�A
Address of Firm:_L!�07— .51qe-Im AA1� 5
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 S b�c -
Existing Water Supply: Public Water Well
Proposed Start Date Estimated time for completion 7- -
ALL 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 the holder of Drain
Layer's License No. 2,6 S 277 Only holders of P-1, P-7 or W-9 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._
,2� i%
Signed: % Print Name.
Licensed Ain Layer
Date: 1 -3-0-7
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE. OF CONSTRUCTION:
BUILDING ADDRESS a O "7
STREET
SUBDIVISION: lJ�' ralg5 SA l OK E S P
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NORTH ARROW
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CONTRACTOR (PRINT) NAME CONTRACTOR'S SUPpRVI R (PRINT)
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STREET ADDRESS SIG E
�, � Ocit" �j�'®r/� �� .�o� �� b �l�I�67 DATE
TOWN STATE ZIP INSPECTED BY TOWN T
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER