HomeMy WebLinkAboutDrain Layers Permit 44 Kimberly Drive P
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7941 C,Qn'ragto COV:E�I C'NSTRUCTION CO.
Location 0044 KIMBERLY DRIVE 'A Ia G >' P•d% F X aJ.27'"<z,
Type Work NEW SAN LAT dT:%0623:8
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Permit No. 7941 »,r:%=>.F'>>>::.:<.:;. Town of South Windsor, CT
Permit Date 06/24/2005 Drain Layer Permit
Expiration Date 07/24/2005
Descrip: 4 ... ;;
Applicant ...:< zY4 Iio'et::to
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Name COVEN CONSTRUCTION CO Yr 0044 IMBE$LY 'DRIVE
Addr. P.O. BOX 427y
�GufifitHAIQNAtEk(Y ANDRE'; L & ANDRE K
COVENTRY f CT 468 y
Phone No. 860)282-Q5
The Drain Layer'<";as$7g �ciisi �"141C1xse issued by the
state and hereby agregs.:tp_ 3 - titian sat' Arth in the
attached 'Conditions' All woxk sail@ 1i esrta wsthnwn of South
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Windsor standards, aI- Q �IA regutx? Yi ,u, `f7t�e axtt'ache.c e`onditions.
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Issued By Tit<� z��' — �— --------------
Date Inspected _____________________ Inspected By
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, Cr
FEE $60.00
Location of proposed work: Lot #_1L
Street No. Street Name
Premises owned by:Nan it! vir
rm• ✓? Phone _��
Address-of Firm: U Ilse)
.TYPE OF WORK:
Lay House Drain Repair
p House Drain ,
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with Tln j//,
Existing Water Supply: Public Water Well
Proposed Start Date 01 Estimated time for completion 6 34 o S
ALL WORK TO BE IN CCO ANCE WITH TOWN OF SOUTH WIND R ST NDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS TTACHED TO THE PERMIT
Permit is to be issued to M,<,44 t, .0 U�_-^f V
Layer's License No. 07 ti� older of Drain
.----_._.._L, . Only olders of P-1, -77 or W-9 licenses
will be issued a permit. PERMIT WELL 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. a� a•SpC� � .
Signed: Print Name: JC hX t ��� d z
*. icen ;DFin Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
err f / I ' 1e I11PIS0H
SANITARY - SEWER LATERAL FIELD LOCATION
DATE. OF CONSTRUCTION:
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BUILDING ADDRESS
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