HomeMy WebLinkAboutDrain Layers Permit 985 Foster Street r TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7385 dounw, Contractor JAMES THROWE
Location Address VANS SEWER & SEPTIC
Type Work RPR .SAN LAT 97 RIVERSIDE DRIVE
VERNON CT 06066
Phone No. (860)289-0095
Date Insp Needed te Insp
Time I nsp Needed 'Csi me , nsp',
Inspected By
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Perri 7385 Town of South Windsor, CT
PermitDate 01 /24/2002 Drain Layer Permit
Expira'tion Date 02/23/2002
Descri;p:
Applicant Location
Name JAMES THROWS Addr. 0965 FOSTER STREET
Addr. VANS SEWER & SEPTIC .Own9r' DZEN JOHN D JR & JENNIFER M
97 RIVERSIDE DRIVE
VERNON CT C7Cafl$6
Phone No. (860)289-0095
The Drain Layer assigned ,th'is permit-1-has a valid license issued by the
state and hereby agrees to all ' the terms and Conditions set forth in the
attached 'Conditions' . Al work _shll ;ki in accordance, with Town of South
Windsor standards, alln OSHA=,_reGuir and tale attached conditions. _
Issued By
Date Inspected 2 3,0 Inspected By _ _
TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL FIELD LO CATION
DATE OF CONSTRUCTION: J�ti
BUILDING ADDRESS � , sT- �-
STREET
SUBDIVISION:
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATURE
C--- DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER
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TOWN OF SOUTH WINDSOR
SANITARY- SEWER LATERAL FIELD LOCATION..
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DATE OF CONSTRUCTION:
BUILDING ADDRESS `-
STREET
+� SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT NAM OF CONTRA' SUPERVISOR (PRINT)
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STREET ADDRESS IG ATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER
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: r , Lot #
Street No. Street Name
Premises owned by: _� r ern o-z""'
Name of Firm: kl— Phone:cx:--5
Address of Firm: sI
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with ^::�0 R 35
Existing Water Supply: Public Water Well
Proposed Start Date Estimated time for completion;U'Jorin
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-C�, the holder of Drain
Layer's License No. Q.QT . 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.
Signed: - - -- - - — - - - ---- -Print—Name— - --
—
Licensed Drain Layer
Date:
Standard FormsTermits\APPLICATION FOR DRAIN LAYERS PERMIT.doc.