HomeMy WebLinkAboutDrain Layers Permit 16 Kelly Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7626 Coxitiracto.r,.'B_APB'ER -UTTLTTIES L.L.C.
Location 16 KELLY RI5 r.eg P:'O BUXi_ 3I
Type Work SAN MAIN
YP } 7TIGT:ON CT_ 0'60' 9
PhQ ie A10 {&6:i ?872-.2334
Date I n s p Needed -------------
Time Insp Needed ------------- _- Time Insp t� .
Inspected By
Work in Progress
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Permit No. 7626 Town of South Windsor, CT
Permit Date 05/05/2003 =: Drain Layer Permit
Expiration Date 06/04/2003
Descrip: CK PMT FEE & ST CUT
I
A licant '
PP LocaC: on
Name BARBER UTILITIES L.L._ C- ddr 1.6 KET+LY_RD
Addr.. P.O.BOX 331 Owner'HOLCOIE
ELLINGTON cw,05029
Phone No. (860) 872-283-0
a.
The Drain Layer-assigned this perttt�t had ualdzcense': ssued by the
state and hereby agzees tp all:: tiie terms end Co'ridibxons set forth in the
attached 'Conditions:' A11 ork skull be-.in_ ace.4>rc ance wit'h.:Tawn of South
Windsor standards, all P HA requ tta,ohed .conditions.
Issued By �� J/'C
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Date Inspected - --- Inspected By
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: 16 V, Lot # 2
Street No Street Name
Premises owned by:
Name of Firm: 'A-4GE(L y/i L_(Tti Es Phone: 37 2—z330
Address of Firm: 'P lao x F3 f' r 4 �7�N
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main x ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with w Y F_ 1 --r- Mlt(w
Existing Water Supply: Public Water_ Well
Proposed Start Date f 7-03 Estimated time for completion ,,
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to ?DA-ui 0 the holder of Drain
Layer's License No.. 27 83 s•9' Only holders of Pi or P7 licenses will be
issued a permit. PERMIT WILL EXPIRE THIRTY (30) DAYS AFTER DATE OF
ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms and
conditions set forth in the permit and attached thereto. Applicant has received Town
Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No. Z 0o 3 1$o 3 787
Signed: Print Name: t")AyiD 6STD' _,tom
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:
BUILDING ADDRESS /c,,ELLV
STREET
SUBDIVISION:
NORTH ARROW �p
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CONTRACTOR (PRINT) NA OF 0 RACTOR ISOR (PRIN )
3 / , ✓iv Cdl r 5- 717��-5
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STREET ADDRESS SIGNATURE
U L)C70 GJ 0 6C52- r DATE
TOWN STATE ZIP INSPECTED BY TOWN
8 6 0-- 6 �7 Z sZ33 C� DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER