HomeMy WebLinkAboutDrain Layers Permit 5 Gorski Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7958 Con trd:Q't`or""'U';ANES%:,TI�ROWE
Location 0005 GORSKI DRIVEddre .g €lzs: VAN :'SFWER`:& SEPTIC
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Type Work NEW SAN LAT µ' 7 I I RS- DE "bPIVE
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Date Insp Needed
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Permit No. 7958 Town of South Windsor, CT
Permit Date 08/25/2005 Drain Layer Permit
Expiration Date 09 24 2005 P
Descrip: NEW SEWER LATERAL C¢YSNEC'ifOT `" y t
Applicant4t ? .ion
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Name JAMES THROWE " p00 �ORS{I D12IVE
Addr. VANS SEWER & SEPTIC"' AS'�OCIATES LLC
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97 RIVERSIDE DIfIVF
VERNON CT 0,6U66
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Phone No
TheDrain Layer':'a a e . a ' 1 z` i sued h
Y J. ` "`< 'Flas..: ``. 1 d a ce se>+zs by the
state and hereby !j.:a xec <:. ].: ;.tlz % rrts>`an'cl' eYdiG: `oz:`'% 'et" forth in the
attached 'Conditions:' Al ::vaos` sa ''< jC `dme..:3�i'ith agZvn of South
Windsor standards, all OSHA r u3re nts4 and the at Ched.;eghditions.
Issued B
Date Inspected �'Ts>�mat' tty _
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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:_ Lot # ��
Street No. Street Name
Premises owned by: Gw
Name of Firm: -� 1� � Phone:
Address.of Frm:
TYPE OF WORK:
Lay House Drain : Repair House Drain
Lay Main ; Lay Lateral-for Commercial/Industrial
Building of acres
Connection will be made with S�f�
Existing Water Supply: Public Water A( Well
Proposed Start Date Estimated time for comP letionV
ALL WORK TO BE IN ACCORDANCE WITH'TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
1,
Permit-is to be issued to �_ ro, the holder of Drain
Layer's License No. 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.
Signed: < Print Name:5�: Af,,V-1,-,
Licensed Drain Layer
Date:s �. GS
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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