HomeMy WebLinkAboutDrain Layers Permit 90 High Tower Road i
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8087 .....
Cont,<r��tor_.JAMES T`HR.O_WE
Location -'' 9 �IGii T{3WIR:, IJ Address: ':.VANS SEWER & SEPTIC
Type Work NEW SAN LAT r 97 RIVERSIVE _DR 4.IVE
FTEANON TT-.;0 6.-6 6.
Phone No
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Date Insp Needed __.5Gr� Date insp
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Time Insp Needed ' -- Timms Irtp -
Inspected By
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Permit No. 8087
Town of South Windsor, CT
Permit Date 09/01/2006 Drain Layer Permit
Expiration Date 10/01/2006
Descrip; INSTALL SANITARY LATI2AL:""`?_.
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Applicant Lt�• . f' .on
Name JAMES THROWS QD9t� NIGHOWR VF2OAD
Addr. VANS SEWER & SEPITIC
' s
f3whr STRZELLCKI F�YSZARD. J & CELINA
97 RIVERSIDE DRIVE.::..
VERNON CT..0CaQ66
Phone No. (860)289-0Q95 -
IE
The Drain Layer assigned }t s p rtyz� 4�as MA id licenses issued by the
state and hereby agrees 't41_l.>zhe 't'erms <anc CO t_:'.for.th in the
attached 'Condition i. ork sh�i1 ......
Ccbr"an. witH Town of South
Windsor standards, all, OSIi '" :qu 're:m z is m_ tk e""attoaC ie
onditions.
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Issued By
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Date Inspected
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--------------------- hYslse�t ed`"Ey:
a 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: 1-� �c:�c r—
Street N Lot#
o• Street Name
Premises owned by: I tv,.L + rz,
Name of Finn: f L C LC, phone: Z GU 1S'
Address.of Firm: 3,
TYPE OF WORK:
Lay House Drain
- Repair.House Drain .
y Main"-------; Lay-Lateral'for Commercial/Industrial
Building of acres
Connection will be made with12
Existing Water Supply: Public Water Well
Proposed Start Date_fLc,, o6
_ 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
Layer's License No. aa? the holder of Drain
Only holders of P-i, P-7 or•W-9 Iice
will be issued.a rlses
permit: PERMIT WILL EXPIRE THIRTY(30)..,DAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to ail the terms
-and conditions set forth in the permit and attached thereto.
Town Street Excavation Permit No. Applicant has received
an ConnDOT Permit No.
CBYD No. 200 4
Signed: � Print Name:
Licensed Drain Layer
Date:
Standard Forms\Perm1ts\APPLICA110N FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY -. SEWER LATERAL FIELD LOCATION
DATE. OF CONSTRUCTION: o�
BUILDING ADDRESS
STREET
-E- SUBDIVISION:
NORTH ARROW
JIL
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CONTRACTOR (PRINT) NAME OF ONTRACTOR'S UPERVISOR (PRINT)
STREET ADDRESS SI E
DATE
TOWN STATE; ZIP INSPECTED BY TOWN
c1: DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER