HomeMy WebLinkAboutDrain Layers Permit 95 Kelly Road 4
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7825 Conga<Cr.�SKIPS°' E3; .IC
Location
Ada r, W. 7 j D. BR6`GX ROAD
Type Work NEW SAN LAB06a-29
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Date Insp Needed �(-Li O'er Fr�Gr"f _. 'r Y q - 9
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Time Insp Needed WIPE
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Permit No. 7825
Town of South Windsor, CT
Permit Date 09/24/2004 Drain Layer Permit S
Expiration Date 10/24/2004 °; g`"' "
Descrip: LAY HOUSE DRAIN
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Applicant l r �,Yr i' LpEi ` gn
Name SKIPS SEPTIC Ett R aIl..
Addr. 27 MUDDY BROOK READ r rO JMARTTN. AROL'D I MAELYN SURV
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ELLINGTON
Phone N _ ,'z.s' :,.:,; `s r
o. (860) 875 2�€32ti; >.� •.'? :;lS<� ?:
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The Drain Layers§igris her s %}�s ued b<� € T 7cgASQ Y
hthe
state and herebya z?e
9 G' u"t 2 the erms anc� co�it itbn t., orCh in the
attached 'Conditions` of South
Windsor standards, al OSIAefuir {nSCe attdy�h�c :; bclitions.
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Issued B � "" >'L5
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Date Inspected 9'
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALT.
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: Lot
Street No. Street Name
Name of Firm: PS Phone: ?7 r 23 32
Address.of Firm: 07 r dG7e V/
TYPE OF WORK:
Lay House Drain_ _ Repair House Drain
- Lay Main..._ _ Lay Laterar for Commercial/Industrial
Building - of acres
Connection will be made with 6 A/C 62�c . 3.5
Existing Water Supply: Public Water Well
Proposed Start Date f-Z8--94- Estimated time for completion 7 r Z�'=�
ALL WORK-TO BE IN ACCORDANCE WITH-TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUrREMENTS-AND CONDITIONS ATTACHED TO THE PERMIT
Permit-is to be issued to the holder of Drain
Layer's License No. 2-a 77 Z Only holders of P-1;P-7 or W-9 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. aadf- l p ?
Signed: Print Naive:--// 7 ,45 "41C '/Z-, ✓z
ens ed_. raid Layer
Date:
ors\PeriAAONOR DAN AERS PRMITdaStandard FmtPI
TOWN - OF SOUTHANDS! '
SANITARY - SEWER LATERAL FIELD LOCAT.10N
DATE OF 1 i
BUILDING ADDRESS
STREET
SUBDIVISION: i-
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