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HomeMy WebLinkAboutDrain Layers Permit 1608 John Fitch Boul , t TOWN OF SOUTH WINDSOR INSPECTION REPORT 'er%ft No. 6720 Contractor CANTON VILLAGE CONST CO tee-ation 1608 JOHN FITCH BLVD Address P.O. BOX 556 'ype ,Work NEW SAN LAT CANTON CT 06019 P _No. (860)693-0122 )ate Insp Needed 1© ��� fi p 3i��? lime Insp Needed _ Z• :nspected By < 4`` } fork in Progress v ° tS'f► g(ItlAu f fi tea. bultx>tZG v5 cor-,PiYaeD� Nc1 � GANTON �I�.�Ata '[ � � t� ' ' E �� �-,C� A f1F Qn�t i �C,LNrcwAL >-S ?►s�aT Tr��L ;4" C�� p ` Date > -iac�5-�, �o�'r��l �(Z wt�� ICcNNfct.T IVCs�J 4>C�l�- 45 CPT. T>)( / '&0111Y S�iZ�li� . LX\Si, &LDGI, AA-0 SAC-f1o�l �_I�n� SA�JI. (Ax6V.AL 'ermit No. 6720 Town of South Windsor, CT 'ermit Date 10/27/1997 Drain Layer Permit :xpiration Date 11/26/1997 tescrip: CONN . FEE PAID #4804 Applicant Location lame CANTON VILLAGE CONST CO Ater6,08 JOHN FITCH BLVD ,ddr. P.O. BOX 556 �1� : tv�rrlBCWELDING & INDUSTRIAL SUPPL IvCANTON CT �(66f46, , - „k 'hone No. (860)693-0122YY �`'a "� � 9,. The Drain Layer ash i h i p rr� a� �r }= c 1 `cense issued by the state and hereby agree1. 'tfrjrnd tja r� set forth in the attached 'Conditions ' -Al `t sf� n a areQ11191 with Town of South Windsor standards, all Id -ched conditions. ssued By v gate Inspected TOWN OF SOUTH WINDSOR } SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: n 3 a BUILDING ADDRESS Soulk vVinSoR STREET : R T S l(goB SUBDIVISION: NORTH ARROW j t fi t _40 ell , r i I _ ' 1 I � I (} S i I 1 1 111 + j GANtorV M1 maG [�p��{1G4; EN �'tNGGR r►A L'o �NL. CONTRACTOR (PRINT) ofNAME OF CONTRACTORS SUPERVISOR (PRINT) �Co Qvwae. R nn��1 STREET ADDRESS SIGNATURE G ANf0nl C 0&1 a DATE TOWN STATE ZIP INSPECTED BY TOWN 8d�O (s 4j 41j DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER APPLICATION FOR DRAIN LAYERS PERMIT yg'O y TOWN OF SOUTH UrMSOR • PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE$25.00 Location of proposed work//O�9 � o� �!�`G'�i L f/� Lot # Street No. Street Name Premises owned Name of Firm: Phone: — Address of Firm: &16 ` TYPE OF WORK. Lay House Drain Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with Proposed Start Date 062�7Estimated 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 gP, the holder of Drain layer's License No. ceaog,s-q Only holders of Pl, 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. Signed: �� Print Name a �c, c, , 9-�, Licensed Drain Layer Date: Z912,71017