HomeMy WebLinkAboutDrain Layers Permit 387 Foster Street i
f TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7736 Con tra_. . :or"" '0C7EAY<>kGQ,ITSTRUCTION CO.
Location 0387 FOSTER STREET A. tea :;P.0 .0 4
Type Work NEW SAN LAT HAS ' GQVEN'TR :, q_.1M' 06 ::, 8
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Permit No. 7736 Town of South Windsor, CT
Permit Date 04/20/2004 4n.•::f: Drain Layer Permit
Expiration Date 05/20/2004
Descri p: ` A..
Applicant - on
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Name COVEN CONSTRUCTIOI# CO 9 : 08 kO IELd 'PREET
Addr. P.O. BOX 427 03 j T MITTGUY EUIN, S., MARGARET C
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COVENTRY Phone No. 860 282 05( ) 2 ¢;
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The Drain Layer a t n'ed "£chi s'>::>.' e': # >:hd: <:>rt .a d lz' eia:se .ssu d b the 1
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state and hereby ' . .: " " .,fort- in the
attached 'Conditions', <th'"T'owh of South
Windsor standards, alb:fOSHA`>.redufri? 1` ;;•FafYcT:;_' h: " `C`taC>Yi'ecE: conditions.
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Issued By T
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Date Inspected --------------------- hn .pe: sd '.:---------
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, Cr
FEE $60.00
Location of proposed work: G5Lot #
Street No. Street Name
Premises owned by: E G ` -
Name of Firm' c� ,V S T . C(
. �h�ne. �1 •� U-? t-�
Address.of Firm: / o
TYPE OF WORK:
Lay House Drain -� Repair House Drain
Lay Main L - ; Lay Lateraf for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Well /
Proposed StartkDate �iANCI
Estimated time for completionALL WORK-TO BE IN ACCO WITH-TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to (2 U4f_ry �Si the holder of Drain
Layer's License No. o-2,� 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.
Print Name: )c
Licens ayer
Date: G 0
Standard Forms\/erMUSIAP CATION FOR DRAIN LAYERS PERMIT.doe
• TOWN OF SOUTH WINDSOR
SANITARY < SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION g
BUILDING ADDRESS
STREET
u SUBDIVISION:
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CONTRACTOR (PRINT) NAME OF ON OR'S SUPERVISOR (PRINT I.
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STREET ADDRESS SIGNA UR
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TOWN STATE ZIP INSPECTED BY TOWN
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TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET - - �� �
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+ SUBDIVISION:
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CONTRACTOR (PRINT) NAME OF COT T R'S SUPERVISOR .(PRINT)
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STREET ADDRESS SIGNAT RE
Co U L A4XCA F DATE
TOWN _-/.- v STATE IP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER