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HomeMy WebLinkAboutDrain Layers Permit 319 Oakland Road Permit No. 7107 Town of South Windsor, CT � , Permit Date 01/10/2000 Drain Layer Permit i Expiration Date 02/09/2000 Descrip: USER FEE PAID CK#0254 Applicant Location Name SZEWCYK, PAUL _ Ad�dr319 OAKLAND ROAD Agdr. 490 COLEMAN ROAD , gwnewlAFfl KEVIN E MIDDLETOWN CT U 7 i3hone No. (860)347-8502 The Drain Layer a484.g6ed th'Ii's permit, has= 1 ua t d i cense issued by the state and hereby agrees ird1 ` t andtd tiohs set forth i n the attached 'Cond i t i ons'�. A 1 ! ;.�v f k s� = t i n apixordsnce with Town of South Windsor standards, al 1` CS rettmeriir , ►ndke attached conditions. ns Issued By E15��A- Date Inspected I �� 9O �nspacted By i TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 7107 Contractor SZEWCYK, PAUL i Location 0319 OAKLAND ROAD Address 490 COLEMAN ROAD Type Work NEW SAN LAT MIDDLETOWN CT 06457 I' Phone No. (860)347-8502 i Date Insp Needed �� �© Date Ins{ . ! Il 00 't j Time Insp Needed Time Insp JtS N0'TD Inspected By Work in Progress Wye � 1FvvA*' I��S— PQf� w.sTAl(�J7 f ��aN� up Ta FoutiQ�7Y�a Q o FSar-kFi l l -;P c�FI . Gas v1ZIAAD oi15L n►7D . arts- Co►.�w�Ec.-r�.�.J ion•►pth;�_�.d,_�,E,;��T,�a;�S�AGk.�r1i�%y�:i R�u� ,✓�Sa�J L�k-5 G�.� . Input Date i i7A jv 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: 3/q 0. i4ot, 9a,w Lot #� Street No. Street Name Premises owned by: Name of Firm: �i9t�L L- Sz 2 wc2�i� ExC Phone:��o 3Y��Sb Address of Firm: 9,6 C'06 ^Az Ro/9P TYPE OF WORK: Lay House Drain Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with j�r "" S 0 K 3 5- Proposed Start Date //— 0� 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 � G �- the holder of Dr ain Layer's License No. _dd 3_7. 91 e Only holders 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 thereto. Applicant has received Town Street Excavation Permit No. and/or ConnDOT Permit No. Signed: ex-�Lt Print Name: Licen Dra n Layer Date: Standard r-ormAPermits\APPLICATION FOR DRAIN LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: ' BUILDING ADDRESS 3►9 �A -��� �A� STREET -�- SUBDIVISION: NORTH ARROW A60Pi 4' � _ eo 1 i = , 1 _ i .7....__ i i I I I I i I i I I _ PA .5-2-e,WCZ XA/ 6,c P4 t/ e,it, C 4 y X 0*� CONTRACTOR (PRINT) NAME OF CONT TOR'S SUPERVISOR (P INT) STREET ADDRESS SIGNATURE /i r Z cu 4, , / ® � ����"� ! lI r7p DATE TOWN/ STATE ZIP INSP T BY TOWN - � Oo 4'-X 7- 9�®'A DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER