HomeMy WebLinkAboutDrain Layers Permit 11 Oakwood Drive 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: 04Kvj 0o D Lot #
Street No. Street Name
Premises owned by:
Name of Firm: mot" Phone:
Address.of Firm: �°t�J:: 14 lej
--. Cf11
TYPE OF WORK:
Lay House Drain `X ; 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-L7-CL-0-5, 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- fz G tS w�.a eve c�er/ the holder of Drain
Layer's License No. 20L{-ter -'1, 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.
10-3i-
Si Print Name: �2/E/ls � u�A167LID
LicepDrain ayer
Date:_//�
Standard Forms\Permits\APPLI=0N FOR DRAIN LAYERS PERMIT.doc
Nov 16 05 07: 38a B&J Construction (860) 225-7906 P. 1
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL - FIELD LOCATION
DATE- OF CONSTRUCTION: Nov-, 9 - Q20 S
BUILDING ADDRESS 1-1' a oo
STREET :
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CONTRACTOR (PRINT)' NAME�F CO SOR (PRINT)
STREET ADDRESS SI r
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TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7996 Contr:aC't'or B&J C'O'NSTRUCTION CO. ,INC.
Location 0011 OAKigO-OD DRIVE Ad'clreso-K <`` 646 < ;flU;2?H 5ItRSET
Type Work NEW SAN LAT p "'
0 B R ITA I:R. T"0::6 0 51
Phon.e.-No _0.6: :),2"
Date Insp Needed
Time
ac�InsP Needed
I'Inspected By
Work in ProgressIn
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Permit No. 7996 Town of South Windsor, CT
Permit Date 11/07/2005 Drain Layer Permit
Expiration Date 12/07/2005
Descrip: INSTALL SANIT. SEWE4- LATERkL`:: %
Applicant Locat :Qn
Name B&J CONSTRUCTION CO.:. I3Q cr 09„13SAiC[4QQp E�RIV
Addr. 646 SOUTH STREET' Cwner CALIO ATHTI't S &..RICHARD J
NEW BRITAIN CT ,OF053,
Phone No. (860)224-0306 .: :
The Drain Layer s igned s Pa'Jiut, his z& � i l}: u se .issu`ed by the
state and hereby ag �klv:!-'` .he"terms"'and coil G.,,4 in the
atta
ched
ed 'Conditions`.-•"All':=;;....: :''`":,. :r.:::<::::;:;.<'>>>_�<:"_?�.:>:'>::: ::? >'s::>::»;:.::;::..,>-s=::':...:';,> '
!Narkad�;ordande w.�.t.h Town of south
Windsor standards, a17;. OSIA :equirri '., ,r.?yy _? h`e._ attaliec<..;ooriclitio
ns.
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Issued B ----- � �� "�
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Date Inspected
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