HomeMy WebLinkAboutDrain Layers Permit 200 Northview Drive a
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. Contractor BARBER UTILITIES L . L . C.
Location Address P.O. BOX 331
Type Work RPR SAN LAT
ELLI NGT ON CT 06029
Phone No. (860 )872-2330
Date Insp Needed c,)rdl CA1) D to If sp ."
Time Insp Needed
1` rile nsp. ; .,
Inspected By
Work in Progress '`
Input Date 3`O _
Permit No. „�.' "r p7399Town of South Windsor , CT
Permit Date 03/20/2002 Drain Layer Permit
Expiration Date 04/19/2002
Descrip REPAIR SEWER LATERAL AT HOUSE
Applicant Location
Name BARBER UTILITIES L. L.C. ' 0200 NORTHVIEW DRIVE
Addr. P.O.BOX 331 ownr ,DUFRESNE GEORGE A & JUDY A SURV
ELLINGTON CT 06q"2�
Phone No. (860)872-2330
The Drain Layer assi nedrtN s p6-rfh—t ,.has a cid license issued by the
state and hereby agrees to it l� the , erma",• and �ohd'TIti ores set forth in the
attached 'Conditions' ,n; ac+cordance with Town of South
Windsor standards, all, t HA „r�e.qu'-'eWrlGnia, art"d 'i attached conditions.
Issued By It 8 �c% " ' NC,
Date Inspected ME Inspected 8y d
1 PORTANT M SSAGE
FOR AS
DATE �A x TIME' -P.M.
M
OF
PHONE
AREA CODE NUMBER EXT NSION
❑ FAX
❑ MOBILE
AREA CODE _ NUMBER TIME TO CALL
TELEPHONED PLEASE,CALL
CAME TO SEE YOU WILL CALL AGAIN
WANTS TO SEE YOU RUSH
RETURNED YOUR CALL WILL FAX TO YOU
MESSAGE
SIGNED
TOPS FORM IIN UOS A
APPLICATION 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:L,00 1eAAJ Lot #
Street No. Street Name
Premises owned "D
Name of firm: U \
� Phone..
T
Address of Firm: C) 00)4,
TYPE OF WORK:
Lay House Drain Repair House Drain •
,
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with F_E L �! GJ
Proposed Start Date IV, 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 ]�fiJ k 0 S i A VEfJ S the-bolder of Drain
Layer's License No. 27IS 3 S-q . Only holders of P1, P 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. Zndj/orConnDOT Permit No.
Signed: Print Name: Zet/r ST7`t7/eA_S
Licensed rain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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