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HomeMy WebLinkAboutDrain Layers Permit 10 Meryl Road t 1 TOWN OF SOUTH WINDSOR INSPECTION REPORT 1 I Permit No. 7247 - Contractor VERNON MINER Location 0010 MERYL ROAD Address 48 OVERLOOK TERRACE Type Work RPR SAN LAT ROCKY HILL CT 06067 ?hpne 'No. (862)202-8925 w i Date Ins p Needed ;. Date. In.sp:. Time Insp Needed Time Insp. Af i 1 Inspected By Work in Progress O%Xz �� - 4 S ;Z r 3 0 Z Input Date Permit No. 7247 gown of South Windsor . CT Permit Date 03/20/2001 Drain Layer Permit Expiration Date 04/19/2001 Descrip: Applicant Location Name VERNON MINER ddr: ,0010 MERYL ROAD Addr. 48 OVERLOOK TERRACE her ERT:EL MARK W & LAURIE M ROCKY HILL CT,.`O6�3 Phone No. (862 )202-8925 ' ;: } The Drain Layer a: sifined this 00, t1t= #1as a 4611d 1 cense issued by the state and hereby agrees tp : the rr andr� t7 ti oihs set forth in the attached 'Conditions ' .` All„ wark 1 I,n acpb°rd,ance with Town of South Windsor stan ards , al QSHA rqu7i�erh�tits, r% tS : attached conditions. Issued By - - -- T �� --- -- Date Inspected 2-d DJ 'nspeeted y -- _.. APPLICATION FOR DRAIN LAYER PERMIT 7 TOWN OF SOUTH WINDSOR N' PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Location of proposed work: t d ./1'I E P-- G/4, Lot # Street No. Street Name Premises owned by: Name of Firm: Phone: I L/ 4 ?'4F Address of Firm: Pb IL L L C— , 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 5 C W I/o Existing Water Supply: Public Water 4- Well Proposed Start Date 3 a-o 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 ))--u o.y t=, e4l 1 61 the holder of Drain Layer's License No. '2-D 4. q -5 . 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. Signed: �d' � Print Name: C- Licensed Drain Layer Date: 3Za- a j a 1 Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc. TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: a (D BUILDING ADDRESS : 4 STREET : AC- R- RAO SUBDIVISION: NORTH ARROW I f ' t ` i_ i i I • , { f. w I t + { t _ I I , , I , 1 � � M CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT) 60-4, (901 s STREET ADDRESS ` SIGNAT RE ,� o uxp I t.�!✓ © 2� U DATE TOWN STATE ZIP INSPECTED BY TOWN PW - ' `'/� ' - DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER