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HomeMy WebLinkAboutDrain Layers Permit 105 High Tower Road i TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 7116 Contractor JAMES THROWE Location 0105 HIGH TOWER ROAD Address VANS SEWER & SEPTIC Type Work NEW SAN LAT 97 RIVERSIDE DRIVE VERNON CT 06066 �Phbn No. (860)289-0095 Date I nsp Needed 3 Time I nsp Needed c3� 71 me TnspS �� Inspected By Work in Progress moo_^moose G. X10— i Input Date .3�Zz f Do Perm t No. 7116 Town of South Windsor , CT Perm1� Date 03/07/2000 Drain Layer Permit Expiration Date 04/06/2000 Descr`�i R: ' Applicant Location j Name JAMES THROWEA�dtr,; 0105 HIGH TOWER ROAD 11 Addr. VANS SEWER & SEPTIC .Owner AUS`SO THOMAS P & JODY E � 97 RIVERSIDE DRIVE VERNON CT Phone No. (860)289-0095 t , The Drain Layer ass i:4��i�,+� th'i�s fermi t :has , a. 7 d . license issued by the state and hereby agrees tc� ,' 1 t � e►� s :and c©tid'itiorts set forth in the ae u attached 'Conditions '.. . l �5k ha I =i n adc�!ddnc6 with Town of South Windsor standards, a 1 1 ached conditions . 3 - Y 00- Issued By J, Date Inspected s``®l® G --- _ � � nspectac By F APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 1 Location of proposed work: � Lot # Street No. Street Name Premises owned by: Name of Firm: V Phone: a Address of Firm: ►u.r, LJr-, TYPE OF WORK: Lay House Drain 210 ; Repair House Drain ; Lay Main - Lay Lateral for Commercial/Industrial - Building of acres Connection will be made with 5-Ok 35 Proposed Start Date G0 Estimated time for completion 32D��Cfo ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS, ALL OSHA REQUIREMENTS AND CONTrev"A__ ONS ATTACHED TO THE PERMIT Permit is to be issued to JG the holder of Drain Layer's License No. 2c 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. 1'1l1(� �� - � 0 Signed: Print Name: Licensed Drain Layer - 7�)q� ir� Date: Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS l �� STREET : 1�7 C7 -I- NORTH ARROW i 3 i s � 1 { 1 - 4 � _ /i L �ut �R� ro IA� �� r . CONTRACTOR (PRINT) NAME !7NTRACTOR'S VISOR (PRINT) STREET ADDRESS SIG E '���p % DATE TOWN STATE ZIP I PECTED BY TOWN 19,aT(--o r�j�T DATE TELEPHONE NUMBER �� WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER ;