HomeMy WebLinkAboutDrain Layers Permit 55 Meryl Road Ill - lll-
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7935 CQ.0 actpr VIOLETS <>:$ILVESTER & SONS
Location '058 414R.YL ROAD ;s""Acldxes� � 65 tRI R." Y kSTRE- T
Type Work NEW SAN LAT <: AiPROEiD Ck 06108
--`
Date Insp Needed ---� � .I. frt�'"<✓` ` " ...
Time Insp Needed `Ian I �� < `f"
Inspected B
P Y
Ins :.
Y n.
Work in Progress
C
+ yy
Date+ --- _�v
Permit No. 7935 �.. :<«.x., Town of South Windsor, CT
Permit Date 06/21/2005 „.-x \ Drain Layer Permit
Expiration Date 07/21/2005
Descrip: INSTALL SEWER LATERAL:>' _''
A licant s%: U:o c 4::tion
pP �x.. �.`
%? y
3'
Name VIOLETTE SILVES ER' & SQN3.....,„:; "i; r. t�''i�55 I'EKYL:;;RQA
Addr. 65 CHERRY STRE$P:,: '`<sH. � a` "::' FARAI7Y' :DENTIS A & BEATRICE M
>r`
z»
EAST HARTFORD ="C'I`: 0 6' 8
i
PkvO a N n 0 2 346 o. 86 89- v ..
:
q� }
f
.ti
d b the
. >";; sue The Drain La er'ass ' `id.,< i s' "" Tb .t.. '' `i d::. ....ar �.
Y g I�6..
+
e.
� Y 5
3%.
}
state and hereby agYeg��::>.tq:`�a?� : ;G,h.� �,�; a,�7;�,::x, td'��.a,�? s. set''>�arth in the
attached 'Conditions' All wakrk sha1;3 .bxta� dari b+xth. Town of South
Windsor standards, al] O: irtti� i , F' he a� dched gbnditions.
Issued By
:
Date Inspected --------------------- Inspected By _
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:' M ef-y ( r-k Lot #
Street No. Street Name
Premises owned by: 'S
Name of Firm: - S Lt,� .�<< c) Phone: a8g- 3�6G
Address.of Firm: S L� ✓� �� S't (-�/ '1,
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main ; Lay Lateraf for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date Y_ Estimated time for completion `a - -b Plf
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 _N the holder of Drain
Layer's License No. P4,o 0 6 Only holders of P-1, P-7 or W-9 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.c OL�-6
Signed: Print Name:
// Licensed Drain Layer
Datk2' ,//b/—
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMTT.doc
TOWN OF SOUTH WINDSOR
SANITARY - SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 6S
BUILDING ADDRESS `
S
STREET
SUBDIVISION:
�Clegaovf L✓�� QH�� o
NORTH ARROW
L _
VIC
T � o
CONTRACTOR (PRINT) NA E 0 C RACTOR'S SUPERVISOR (PRINT
C57cf P rr y s 7�
STREETT ADDRESS �/ / SIGNATURE /
r 9,s t /7r-r l- o/'al c-7- 0,�0 T l Z Z ATE
TOWN STATE ZIP INSPECTED BY TOWN
$6 Q 21- 7— 3y6,6 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER