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HomeMy WebLinkAboutDrain Layers Permit 140 Overlook Road APPLICATION FOR DRAIN LAYERS PERMIT TOWN OF SOUTH UMMSOR y 7` Z PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE,25.00 Location of proposed work: / Vo Lot # Street No. Stet Name Premises owned by rr)-S Name of Firm: Phone: 2E f6 i�' Address of Firm: L �✓�Grr G�� TYPE OF WORK: Lay House Drain Repair House Drain Lay Main Lay Lateral for Commercial/Industrial Building of acres Connection will be made with - •�� 35: e7 Rg Pro osed Start Date/ � ��Estimated time or coo tenon U p .f p 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 Drain layer's License No. 3 Only holders of Pl, P7 8a 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. (772 703 ca YO �N Signed: Print Name Licensed Drain Layer Date: I TOWN Or SOUTH WINDSOR INSPECTION REPORT lermit No. 6647 Contractor JAMES THROWS .ocation 0140 OVERLOOk. ROAD Addre--s VAwS SEWER x SEPTIC ype Work NEW SAN LAT 2-22 TROY ROAD SOUTH WINDSOR CT 06074 Phone f`No (EI,60)289-0095 )ate Insp Needed -ime Insp Needed ��,_ __— Time I sp .nspected By - �' T bvas +lark in Progress awf did A s Cap o�en�y 1I►SpPc7�ih, of ������. r S o©"4 / ®I�1P �Y,> ��cr>�a��2atk / a�► .sre I n p Date --------------------------- Per,ni t No. 6647 Town of South Windsor, CT Permit Date 07/16/ 1997 Drain Layer Permit i Expiration Date 08/15/1997 Descrip : Applicant Location Name JAMES THROWS Addr , 014Q OVERLOOK ROAD Addr, VANS SEWER & SEPTIC wngr� N►INNEIELD HO#2ACE&BARBARA J SUR 222 TROY ROAD SOUTH WINDSOR CT r0fO74 Phone No. (860)289-0095z The Drain Layer ass fgn` 0 thils berm ft has a a-I id license issued by the state and hereby agrees t0' 1Sk �1 the terms, end c©Y�d1 t:iQnS set forth in the i attached 'Cond i t i ans ' ; fA 1 wor`k shal=l ;be, ,i:n ac�sn�l�ai�cQ with Town of South I Windsor standards, all OSRA requirements, srtd 'th attached conditions . i . '� Issued By�_� Date Inspected _ Ark,(-nspe '�ed,.8y � .___