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HomeMy WebLinkAboutDrain Layers Permit 45 Petersen Way } - TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No 0 Contractor SKIPS SEPTIC Location Address 27 MUDDY BROOK ROAD Type Work NEW SAN ELLINGTON CT 06029 Phone> No. (860)875-2332 Date Insp Needed , Da#,e:e TOO" Time Insp Needed TIme' Insp5 1JoT€� Inspected By 55Q Work in Progress WIt c>s F� A h- AIVD C.�A11 -CONgR�Ca'riR• �f? i3.1�E Ar�"� `Di��V`Ta �. �V !�R -�C. � 4,CO,... q( ox. boa Pr tkr�L josi=at( j $,, `Inp�1t-` Date "0 8:S4 prM,4�2 aD2-2 tc3 t�'I�Z3�c��EsT-cat 13�.(-- 1 C,oN�'RPrQp� u�©tom STD � Y�E�J RS��1�' �1lfl �N. PerVo. 7400 Permit Date 03/28/2002 Town of South Windsor, CT Expiration Date 04/27/2002 Drain Layer Permit Descrip: Applicant Location } Name SKIPS SEPTIC ' Addr. 0045 PETERSEN WAY Addr . 27 MUDDY BROOK ROAD - QWrlle'r,,aGUERRA ARTURO ELLINGTON CT .-06� Phone No. (860 )875-2332 The Drain Layer assigned ihis :Peirmit has a valid license issued by the state and hereby agrees 'to",a14 the, terms and cond,itiur�s set forth in the attached 'Conditions ' . A'1 1 work sf��i1�,1 '�bc� � i n acc� -dance with Town of South Windsor standards, all OSHA requirements and the` attacherl conditions . ssued BY — �- Title, •- e - )ate Inspected _ _ �nspectecl By { 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: 'ems 0V Lot # Street No. Street Name Premises owned by: 4-IC-714-20 l c 1Z2,4 Name of Firm: J K(PS CP77 C- Phone: "�'z-3 3 7- Address of Firm: 2-? M c4D�y TIZ 06k JZD L 4-1n1 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 (; r1 PVC- Proposed Start Date ¢Z-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 TDB Guy kF/Z the holder of Drain Layer's License No. _ Zo 7,2 7-, 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. C6�1�- �oo � Iet� � Iql Signed: Print Name: VMX#1 &1#*4AC/Z- �rc Licensed Drain Layer Date: 3r 2 -v z.- Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: 9 o BUILDING ADDRESS 'S STREET Sahj + SUBDIVISION: NORTH ARROW 3_. ._•._--- __-- __ + ! I 4 t i , 13-1 { i , i1 c • f lilt k t t 1 r L( �/jj 7_-- Gt , , ! T 1 ! t 1 1 5;KlfS SrL rTIc TANt SfreoGS °) I C WAf l CA5K+ CONTRACTOR (PRINT) NAME OF CONTRA TOR' PERVISOR (PRINT) a� muyo-7 ls.evve- /ZG' - STREET ADDRESS SIGNATURE L L J N ( CT Ea0 _ DATE 17 TOWN - STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER