HomeMy WebLinkAboutDrain Layers Permit 40 Palmer Drive Aft
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No, 77 Contzaotor SKIPS"'SEPTIC
Location A'dreS;e.€ +`':>=.27 MiJA1 C BROD.jC ROAD
Type Work NEW SAN LAT 'I�, NGT�N..,ZT::06029
Phone:*''t3o (8 0}8 5 ;'2332
Date Insp Needed /�U Y__ ISate Txasp t'i� _
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Time Insp Needed
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Inspected By Ann.O l
Work in Progress sx� SrS
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Permit No. 8077
Permit Date 07/27/2006 Town of South Windsor, CT
Expiration Date 08/26/2006 Drain Layer Permit
Descrip: NEW SEWER LATERAL C9
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Applicant Lc7pat3:on
Name SKIPS SEPTIC
Addr. 27 MUDDY BROOK ROADdr Q &Q PATMER DRIVE,
(�4T3xer PARSONS
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ELLINGTON CT 06029
Phone No. (860)875-23.32-;:,`
The Drain Layer as�zned Ghjs p�f{flsk his salad laqense -ised by the
state and herebyccrrF 'xt: eris:> set::::forth in the
attached 'Conditions ...>ons . .
»A`1 '':
x h .l I;?;} :« X1a c an: °cv...t _.
Windsor Stan >::;:_:».a«3::<::<:;rv:<::;<;.:,.. h Town of South
standards, al`1 OSIA'''requ e3d its),> ici: IT- atta'Cfied%:.coriclitions.
Issued By —
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Date Inspected
-------------------- Ynspe�t..�d:.:.::gy --
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: lk77Lot#
Street No. Street Name
Premises owned by: f N A 'f�IZ S o S
Name of firm: 6'�e %::)S S C P 77 Phone:
Address.of Firm: 7 u
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main"------; Lay'Lateraf for Commercial/Industrial
Building of acres
Connection will be made with V C,
Existing Water Supply: Public Water X Well
Proposed Start Date 7"71 -
Estimated time for completion z
ALL WORK TO BE IN ACCORDANCE WITN*TOWN OF SOUTH WINDSOR STANDARDS
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit-is to be issued to �flll-)erl the holder of Drain
Layer's Ucense No. Z7 7 z f . 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. �00 G Zk;U.. 3 2 a-
Signed: 1 Print Name:_
Ucensed Drain Layer
Date: 27- 0
standard Forms\Permits\APPI ICKTION FOR DRAIN LAYERS PERMIT.doc
TOWN OF :SOUTH ANDSOR
SANITARY - SEWER LATERAL FIELD - LOCATION
DATE. OF CONSTRUCTION: z� 06
BUILDING ADDRESS
STREET .
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SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRI / NAME OF C CTO PERVISOR (PRINT),
STREET ADDRESS - SIGNATURE
t DATE
TOWN - STATE ZIP INSPECTED BY TOWN � 31
DATE
TELEPHONE NUMBER _
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER