HomeMy WebLinkAboutDrain Layers Permit 1400 Main Street TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7414 Contractor H. W. LEVACK CO.
Location Address 49 MASCOLO ROAD
Type Work N SOUTH WINDSOR CT 06074 I'ne No. (860 )528-0131
Date Insp Needed , IIQ s
Time Insp Needed ' _a
Inspected By
Work in Progress
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PermtllhN$. 7414 mown of South Windsor, CT
Permit Date 05/01/2002 Drain Layer Permit
Expiration Date 05/31/2002
Descrlp:
Applicant Location !
Name H. W. LEVACK CO. _ .r dr, 1 0 MAIN STREET
Addr. 49 MASCOLO ROAD r AR , TINO RICHARD P+ERIKO TRUST
SOUTH WINDSOR CT
Phone No. (860)528-0131 �
s _
The Drain Layer a s s as .-�1 'cense issued by the
state and hereby agr nd 1 s set forth in the
attached 'Conditions' .,__,,_,AA n a with Town of South
Windsor standards, al � ched conditions.
Issued By c
Date Inspected S" - Zoo s 0 y
---APPCICATI FORDWARN LAYER PERMIT _
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
•. TOW -HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work /ybz) ��I/A", Lot #
Street No. Street Name
rese3�wfled-bq
Name of Firm: 4zzz,) Phone: S�5;1 Z;�/
Address of Firm: G / S Z_,
TYPE OF WORK:
Lay House Drain; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Proposed Start Date S_� Estimated time for completion 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 4c') the holder of Drain
Layer's License No. e� Y XX 7 Only hold 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-- Applicant has received Town Street Excavation
Permit N and/or ConnDOT Permit No.
Signed: Print Name: J/
Licensed Drain Layer .
Date: S v
__ _----------- -----standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL 'FIELD LOCATION
DATE OF CONSTRUCTION: ' _ -
BUILDING ADDRESS
STREET : � L�
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CONTRACTOR (PRINT) NAME IFCONTRACTOR'S SUPEVISOR (PRINT)
STREET ADDRESS U
TOWN STATE ZIP INSPE TED BY TOWN
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6 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER