HomeMy WebLinkAboutDrain Layers Permit 12 Kelly Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7625 Cont'rac-tor_. BARBER,.UTILITIES L.L.C.
Location 12 KELLY RD Address:: P :O BOX,33�
Type Work SAN MAIN ELLINGTON CT06029
Phone NO: ($60;)a 2 233Q
Date Insp Needed ---------------
Time Insp Needed ------------- — Time Insp
Inspected By
Work in Progress
Input Date
Permit No. 7625 Town of South Windsor, CT
Permit Date 05/05/2003 Drain Layer Permit
Expiration Date 06/04/2003
Descrip: CK PMT FEE & ST CUT
Applicant I ocat'> on
Name BARBER UTILITIES-L L,C. ?kdt9 1.2 KET.LY 'RD
Addr. P.O.BOX 331 Ownet—ffOLCOM$E <
ELLINGTON CT 06:029
Phone No. (860)872 2330
The Drain Layer.;,assigned tkiis pertttit had d.. ;a11d license Issxed by the
state and hereby agrees tp he tents and conditions set forth in the
attached 'Conditions' A:11 atorlc .s.k�a11 be irx accordance wa th:,Tawn of South
Windsor standards, all OSFTA reejuxre[nen s�„ r�, the' atta:ehed ,conditions.
Issued By --- 11t1e y x! 7 -----------------
Date Inspected .................... Ins ecteii B
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: 75"'12- I<,CZ�V ��, Lot #
Street No. Street Name
Premises owned by:
Name of Firm: ►3 6 YL t�r c�� `� Phone: 67 2--233 a
Address of Firm: 331 eLc.1Nc, 7Z)A-J <�:-;� 06021
TYPE OF WORK: '
Lay House Drain; Repair House Drain
Lay Main Xr ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 14 Y9 #7 ml+tlj
Existing Water Supply: Public Water X Well
Proposed Start Date 5� 7-0 3 Estimated time for completion t �.✓� r�
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to D Ate\z) :s7-A-Li S the holder of Drain
Layer's License No. Z?S`3!,j7-q Only holders of P1 or P7 Licenses will be
issued a permit. PERMIT WILL EXPIRE THIRTY (30) DAYS AFTER DATE OF
ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms and
conditions set forth in the permit and attached thereto. Applicant has received Town
Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No. Zoo 3 /6o 3 c)8 ?
Signed:JX2:LPrint Name: 'fir 0 .5'T)9-44-/05
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION::
BUILOING� ADD.RE ,$ aLV
STREET
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CONTRACTOR (PRINT) NA OF 0 RACTOR' ISOR (PRINT)' IN
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STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
72'-Z33o DATE
TELEPHONE NUMBER, .
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER-