HomeMy WebLinkAboutDrain Layers Permit 81 Palmer Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7759 Cont.:ra' or JAME5`°THROWE
Location
A'ddre VANS SEER &::SEPTIC
Type Work NEW SAN TAT
RIVE'RS.IDE:.DftVE
'EFERNQ1 :'CT 06066
hone No ....°.��:r0)289-0095
Date Insp Needed bate Issltit
s ( - _
r
Time Insp Needed ------------ P"ime IaV ;
Inspected By
�-�_ C
Work in Progress �'�� /
�S"
-
-�' --F----a .[---Cave_T
Cellis— fit//� Input - _ > Date<--- �_
Permit No. 7759 Town of South Windsor, CT
Permit Date 06/16/2004 Drain Layer Permit
Expiration Date 07/16/2004
Descrip:
Applicant Lbeation
Name JAMES THROWE Adder A081 PAL:MER 3]RIVE_
Addr. VANS SEWER & SEPTIC tvtn`er VONKAENE.L JOHN E. &
97 RIVERSIDE DRIVE ::
VERNON CT 06066
Phone No. (860)289-0095
j
3 f
The Drain Layer ass�gi-e this pe h s� yalad l�:cense issued by the
v f{
state and hereby agiees t 1 the `t`drriis ixd CrrYrz it7ard9 set. forth in the
attached 'Conditions' . All wak sha3l .ri aCDfdanee oait.h Town of South ;
Windsor standards, all OSHA requir cr nts :and tie attached;.donditions.
I
Trtle., -,
Issued By ---�-_- - -- ---------------------
Q¢
Date Inspected -------------
---- -
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, Cr
FEE $60.00
. ..Location of ro � � . Pa. �
p posed work. � Lot# .
Street No.
j Street-Name
Premises owned b : At'\ del !(c v
Name of Firm: Phone:.
G�
.
Address-of firm: cl L d r
1YPE OF WORK:
Lay House Drain Repair House Drain
Lay Main"-----; Lay Lateran for Commercial/Industrial
Building .of acres
Connection will be made with
Existing Water Water Supply: Public Waterer well
Proposed Start Date Estimated time for completion l
ALL WORK-TO BE IN ACCORDANCE WITH-TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUfREME AND CON MONS ATTACHED TO THE PERMIT
Permit-is to be issued to,--- q,5 ro the holder of Drain
Layer's License No. 209-6 ate_, Only holders of P-I, P-7 or W-9 licenses
will be issued a permit, PERMIT WILL EXPIRE THIRTY.(30)'DAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer.hereby agrees to all the terms
and conditions set forth in the permit and attached thereto.- Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
.CBYD No.
Sign
Print Name:
Licensed Drain Layer
Date: /6, ( L1 .
Standard Forms\Perm1t$\APPLIC0M0N FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
• �al
BUILDING ADDRESS l �r►-t,�-�
STREET
SUBDIVISION:
NORTH ARROW
311
M.
J
MLP =4 _vr
VSen/7 uc,
CONTRACTOR (PRINT NAME OF CO TO
R'S SUPERVISOR (PRINT)
121
STREET ADDRESS G TORE
O 0660i. � ��i9lQ'I DATE
TOWN STATE ZIP INSPECTED BY TOWN
-alw9 00�5 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER