HomeMy WebLinkAboutDisconnection 398 Nevers Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7251 Contractor ROTO ROOTER
Location 0398 NEVERS ROAD Address 15 BARBER POND ROAD
Type Work RPR SAN LAT BLOOMFIELD CT 06002
Phone No. (860 )727-9500
Date Insp Needed 6Y 0 I Date .Insp Ol
Time Insp Needed ' 'fame 'Ins,p;,
Inspected By
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Permit ;►Vo. 7251 Town of South Windsor , CT
Perm t*Date 03/26/2001 Drain Laver Permit
Expirat-ion Date 04/25/2001
Descrip
Applicant Location
Name ROTO ROOTER Addr.." 0,,398 NEVERS ROAD
Addr. 15 BARBER POND ROAD � -OWner GRAUSHINSKI MILDRED W
BLOOMFIELD CT Qp!-1 2
Phone No. (860 )727-9500
The Drain Layer a, - tli-'s peg' 1 t has �fal.i d license issued by the
state and hereby agrees_ to 414 the °.terms°:;,and conditions set forth in the
attached . Conditions g . A 1 i ►pork `s1 11 fie,.J n accordance with "Town of South
Windsor standards, aT,,,1, -,` e #� ehte,} and tie attached conditions.
Issued BY
Date Inspected ___� 3�v� olj � _r_ Thapected 'By ^:5�.�L�.n?�,- --------
APPIICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work: 3 l� -ror,� 3 4�� , Lot #
Street No. Street Name
Premises owned by: r(f C/ 4� c-1 slC
Name of Firm: /Qdll-r 'ee d,'cY- Phone:
Address of Firm:
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date 'Tlz-�101 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 ,,can the holder of Drain
Layer's License No. ,e0 /-je22 4j?" 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: Print Name: �e h n �e All
�- Licensed Drai Layer d l/ br(re Aq
Date: / Z
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Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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DATE OF CONSTRUCTION:
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TOWN STATE ZIP INSPE ED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER