HomeMy WebLinkAboutDrain Layers Permit 788 Main Street Permit No. 6479 Town of South Windsor, CT
Permit Fate -09/12/1996 Drain Layer Permit
Expiration Date 10/12/1996 -
Descrip: HOMEOWNER MAKING REPAIR
Applicant Location
Name Addy . 07t38 MAIN STREET
Addr .. Owne.r'BtAkE JOHN C. .
Phone NO.
The Drain Layer ashigned ;thrs permitt. fas vai3d1itense issued by the
state and hereby agrees- tor ,lil,i`''th'. 'terms;',,and a-6nd1it4 n, set forth in the
attached 'Conditions ' '. Al . 4�ork shall,fi'�i "�be,' in aceor'dat'ic with Town of South
Windsor standards, a 1 l OSHA:,=,requ i rerl"►eti1;8, and the =attached coed i t i ons.
y
Issued By -
/
Date Inspected 9®��< Inspected " By4f -_- / z-
TOWN ,OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6479 Contractor HOMEOWNER
Location 0788 MAIN STREET Address SAME AS ABOVE
Type Work RPR SAN LAT SAME AS ABOVE
SOUTH WINDSOR CT 06074
Phone No. (v00 )000-0000
Date Insp Needed z3� � _ 1?ate Insp.
Time Insp Needed CAI '" me ' Thsp.
Inspected By
Work in Progress .�__� .�► -�. -r�� >' .�,e. ;r + . ,✓ - _ .s�v •��
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Tnpuv Date
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APPLICATION FOR DRAIN LAYERS PERMIT
• ` TOWN OF SOUTH VANDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: r 1 h k) D,� ' `T Lot #
Street No. Street Name
Premises owned by: 13 k- L,PV-tz__
Phone:
Address of Firm:
TYPE OF WORK.
Lay House Drain Repair House Drain V ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
11
Connection will be made with (10 Pv G
Proposed Start Date Estimated time for completion W£ L
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 C L �- the holder of Drain
layer's License No. Only holders of P1, P7 & W9 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.
2aSigned: Print Name J'0 44�
Prainhaye
Date: 9 /L 6