HomeMy WebLinkAboutDrain Layers Permit 797 Foster Street Ex TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8005 Con.:tr'ac.__or ,,5..rIPS 8'E-R_T.IC
Location 0797 FOSTER STREET EXT Address ? MBD:Iy i3ROO,K ROAD
Type Work NEW SAN LAT E:LLNGPON C. 0&>.p29
Phoe.Nq. 1$ 6175 23�2
Date Insp Needed OdtSA 1) _Y date Iris.
Time Insp Needed
Inspected BY
Work in Progress1� /!ram! uJsfl?
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Inpixt _ Date
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Permit No. ,8005 Town of South Windsor, CT'
Permit Date 11/21/2005 Drain Layer Permit
Expiration. Date 12/21/2005
Descrip: INSTALL SANITARY SEWER"_L4 ERAL •.•"':,,r:
Applicant LOGat: on
N ST E> T EXT
Name SKIPS SEPTIC E
Addr. 27 MUDDY BR00K,.ROAD A 8VR>R �J ItN
ELLINGTON 06029 !
Phone No. (860) 875 1332
The Drain Layer assiga�ed ,th:is p� fnit ha`s%; ?zaid � eeTzs&,>`"issued by the
state and hereby agrees, tp, a33,;the terms., : nd condi;rroris-.:;set forth in the
attached 'Conditions' -A11 work shad bi ad :adarace w1t1bwn of South
Windsor standards, aLl OSHA requsreinen :. rrd tie sZtt' ched-,gonditions.
Issued B — .. _ Title14
:
Date Inspected ------ Inspected By ='
CT
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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: 9 sT- ExT
Street No. Lot #
Street Name
Premises owned by: V r ti
Name of Firm: cS'!�(fP S
Phone: 87, 2
Address-of Firm: O. Sox 29 �I,J 6-v
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TYPE OF WORK:
Lay House Drain X" Repair House Drain
L.ay Main - ; Lay Lateral"for Commercial/Industrial
Building of acres
Connection will be made With � 7>VC SS-4-),IZ- 3-Y—
Existlng Water Supply: Public Water_______ Well
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 G,%,�,��
Layer's License No. the holder of Drain
will be issued.a Only holders of P-1, P-7 or W-9 licenses
permit. PER 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 o 4?p p - -
*Ul
Print Name: // I�AS CJ�tZ �Drain Layer
Date: - Z/- 0 r -
Standard Forms\Permits\APPLICA'TION FOR DRAIN LAYERS PERmrr.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: I b�
BUILDING ADDRESS �1 `1
STREET Fcr ST r
SUBDIVISION:
NORTH ARROW
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CONTRACTO�PRINT) HIE OF CO OR'S S ERVISOR (PRINT).
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STREET ADDRESS SIGNATURE /
Eu-(JvLl0 LI D(00�cj �` � :�� / DATE
TOWN STATE ZIP INSPECTED BY TOWN
- -_fib o DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER