HomeMy WebLinkAboutDrain Layers Permit 779 John Fitch Boule Q
f TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6994
PING
Location 0779 JOHN FITCH BLVD Address tor 271FOLSHMOAKLANDAROAD
Type Work RPR SAN LAT MANCHESTER CT 06040
F?ho`rie,"No. (860)646-5888
Date Insp Needed
Time Insp
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Date
Pert No. :6994 Town of South Windsor, CT
q3-e-!71 t Date 06/01/1999 Drain Layer Permit
„Expiration Date 07/01/1999 .
Descrp: REPLACE TANK W/GRIT SEPERATOR-TIE INTO EXIST. LAT.
Applicant Location
Name FOLSOM LANDSCAPING r b,779 JOHN FITCH BLVD
Addr. 271 H OAKLAND ROAD r O L OIL CORPORATION
MANCHESTER CT `
Phone No. (860)646-5888 �}
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The Drain Layer a s r s 1 cense issued by the
state and hereby agr t � � and � s set forth in the
attached Conditions' . - 1 �� k s w �" n a p3 with Town of South
Windsor standards, alb " d �t ched conditions.
Issued By A #E
Date Inspected - 6 i s
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: T_7 /�
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BUILDING ADDRESS. : - 77 9 T'oh n Fs h 9t,��
STREET
SUBDIVISION:
NORTH ARROW
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1:�X,508 CON ISTtZUCTI ON KOSeET MAoIASY
CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUP RVISOR (PRINT)
0Atq—AND ST.
STREET ADDRESS S N RE
MANG1412,STER- CT o(oo4(6 /Z,5 DATE
TOWN STATE ZIP INSPECTED Y TOWN
52�3— �`►�� DATE
TELEPHONE. NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
094-
` APPLICATION)FFOR DRAIN LAYER PERMIT
tOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE ��
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work: -7?9 Jo r 9.v h Lot #
Street No. Street Name
Premises owned by; ---6r•W �r
Name of Firm: I��, ,-� cams 61CM. Phone: 52k- 8G 2
Address of Firm:
TYPE OF WORK:
Lay House rai0 ; Repair House Drain ;
-- Lay Main ; Lay Lateral-for Commercial/Industrial
Building of acres
Connection will be made with ✓hvl�
Proposed Start Date O "� Estimated time for completion s
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 /adrs the holder of Drain
Layer's License No. e10 4AAO _ Only holders of P1, P7 &W9 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.
5;p Z � � SS
Sign Print Name:
c sed Drain Layer
Date: '�0//Z.g 1
Standard Forms\Pennits\APPUCATION FOR DRAIN LAYERS PERMIT.doc