HomeMy WebLinkAboutDrain Layers Permit 43 Lipman Drive (3) TOWN OF SOUTH WINDSOR INSPECTION REPORT
Fermi t No *
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Contractor LATULIPE BROS. INC.
_ocat i o nLI Address 780 VERNON STREET
MANCHESTER CT 06040
ype Work NEW SAN LATP.. ,o No. (860 )646-5114
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Permi"tN 7599 Town of South Windsor, CT
Permit 'Date 12/02/2002 Drain Layer Permit
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Expiration Date 01/01/2003
Descrip. CK 2122 $122 . 50 CK2123 $60.00
Applicant Location
Name LATULIPE BROS. INC. r. 9,0 IPMAN DRIVE
Addr. 780 VERNON STREET KYLE R &
MANCHESTER CT 0
Phone No. (860)646-5114
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The Drain Layer as s s cense issued by the
state and .hereb afire t nd s set forth in the
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attached Conditions' a with Town of South
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Windsor standards, al u ched conditions.
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Issued By
Date Inspected s e y / 3.u,
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LL BEFORE YOU DIG - CT) 12/@2/2002 09 :51 :27
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-GV -OT 3-SW SWIND9 -T5
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***** EHERGENCY *****
T�ME. . W9 :49 0ATE, . 12/W2/2��2
REQUEST NO. . . 2�0249V3�97
LA-ITi�DE 41 8373N5
WlMDSOR
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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: 343 1,1114Y" -3
Lot
Street No. Street Name
Premises owned by: -2�5 KREB-c->
Name of Firm; L.A_`UL)WC- 666 i N6ER S )n/L Phone:
Address of Firm: 7S 9 V'-C R N 9r\) S► /V7/gMCA/'6S'-,5 ig C
TYPE OF WORK:
Lay House Drain_; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with P V C- S rR R 3�
Existing Water Supply: Public Water_ Well
Proposed Start Date_/Z _3' o'2-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 NOR MArh L A ' L)L I PPE the holder of Drain
Layer's License No. 758' . 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. �g2 � ooJ4�
Signed %� ,
9 Print Name: /t/omi9r1/ 4147-UL 1p10E
Licensed Drain L er
Date: �1 o
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY S..E,WER LATERAL . .FIELD LOCATION
DATE OF CONSTRUCTION: �' 41 2�9
BUILDING ADDRESS
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATURE
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TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER