HomeMy WebLinkAboutDrain Layers Permit 401 Governors Highwa TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7998 CoAtractor UIOLETT'E $ILVESTER & SONS /
Location �t k' 2 'A ,Address 55 CFI RI2Y .STREET
RPR
Type Work SA AT aST ITARTFO?D,- CT 06108
Phone Na3466
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Date Insp Needed7ate Ir
Time Insp Needed Iimen
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Inpub _ _ Date
Permit No. 7998 Town of South Windsor, CT
Permit Date 11/15/2005 Drain Layer Permit
Expiration Date 12/15/2005
Descrip; CK37907
Applicant Tocation
Name VIOLETTE SILVESTEI2 & SONS Addy - p401 GOV.ERNdkS`'HIGHWA
Addr. 65 CHERRY STREET Qwxzer v�ILtTE3T'ER :RI CHARD TRUSTEE
EAST HARTFORD CT 061�$
Phone No. (860)289-3466
The Drain Layer asserted this permit his a' val 3cen e issued by the j
state and hereby agrrses`ta a17 -the berms aid. pnditicns set ;forth in the 3
attached 'Conditiots' . All worl€ sha g _in aceord.
ance-with Town of South
Windsor standards, 11 OSHA re.quirement�e:**and the. att:ached.,.conditions.
Issued B
Date Inspected
p hris ected B-------------
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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: Iv -
Name of Firm: 101o c.Sr/ate � ��
Phone.: �.
Address.of Firm: S�C���-. S�
TYPE OF WORK:
Lay House Drain ; Repair House Drain X
Lay Main '
Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water X Well
Proposed Start Date Vll.PI_ 67S 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 _o e e holder of Drain
Layer's License No. �-; 5_F 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 recelved
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No.cp d
Signed-
Print Print Name: �a� l o.,
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc