HomeMy WebLinkAboutDrain Layers Permit 77 High Tower Road i
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7659 Contra°ct`or JAMES°>:T:.H.ROWE ;
Location 0077 HIGH TOWER ROAD .A'ddr..es i'i' i VANS:'
SEWER"<& SEPTIC
Type Work NEW SAN LAT
„ 9.7. RIVERS-DE. DRIVE
fERNOhT .>CT 0:6 0 6 6
one No 289; 0`095
Date Insp Needed n:Dates Ia
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Time Insp Needed Time
Inspected By
Work in Progress
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Permit No. 7659 Town of South Windsor, CT
` Permit Date 09/10/2003 Drain Layer Permit
Expiration Date 10/10/2003
Descrip:
Applicant Lbc.ation
Name JAMES THROWE A1dY 0077 HIGH TOWER ROAD
Addr. VANS SEWER & SEPTIC Owner kRIAN ALLAN SUZANNE SURV
97 RIVERSIDE DRIVE "'
VERNON CT-, 060
Phone No. (860)289 0095
The Drain Layer assi :ied this permit has 'Valid 13.cnse,.issued by the
state and hereby agrees -.to all the teYms a4d conditions set_:.foth in the
attached 'Conditions' All work shall be in aceardance with Town of South
Windsor standards, all OSHA. -ari. the. attached bAditions.
Issued By -----------------
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Date Inspected ---- ----"—` �-----
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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: '7 7 Lot #
Street No. Street Name
Name of Firm:- Phone: 2259C,r>7S
Address-of Firm: oi
TYPE OF WORK:
Lay House Drain—Jd ; Repair House Drain
Lay Main ; Lay Latera-f for Commercial/Industrial
Building of acres
Connection will be made with SD23 5'
Existing Water Supply: Public Water. Well
Proposed Start Date 4 2 3 Estimated time for completion /! lo-3
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 we_.- 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. _2c.43 3? 70b3-3 1 ,
Signed- Print Name: �� i� --
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY - SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS 77 44L�CJL
STREET
SUBDIVISION:
NORTH ARROW
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ONTRACTOR (PRINT NAME OF CONT�R' SUPERVISOR (PRINT)
STREET AAD R`ESS VATURE
�0(� , I� Q, 9//ZL DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER