HomeMy WebLinkAboutDrain Layers Permit 100 Pine Tree Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 7595 Contractor CORREIA EXCAVATORS INC
Location tQ��It Address 47 SMITHBROOK TERRACE j
Type Work NW GLASTONBURY CT 06033
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Date I nsp Needed n I l 2 j
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Time Insp Needed (o
Inspected By
Work in Progress Fro.+1 ST 6
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Town of South Windsor, CT
Permi" No. 7595 Drain Layer Permit
Permit%Date 10/30/2002
Expiration Date 11/29/2002
6escri`p:
Applicant Location
Name CORREIA EXCAVATORS I dW. o OREUXEANNEE LANE
Addr. 47 SMITHBROOK TERR
GLASTONBURY
Phone No. ( )
y� 4
The Drain Layer i has
icense issued by the
state and hereby ag 1` t J an 1 ns set forth in the
attached 'Cond
ition ' . A n e with Town of South
Windsor standards, a e tached conditions.
Issued By
Date Inspected R, By `
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT e
FEE $60.00 '
Location of proposed work: f 0 a At.e lt� Z47Y.N/ Lot #
Street No. Street Name
Premises owned by:
Name of Firm: 60A2-,P� " c Zjd Phone:
Address of Firm: �" r� 7-
TYPE OF WORK:
Lay House Drain C ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 0' G' 6 it
Existing Water Supply: Public Water Well
Proposed Start Date J1, Zdz Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS A D CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to ( the holder of Drain
Layer's License No. G: Only holders of P1 or P7 licenses will be
issued a permit. PERMIT ILL 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.
Signed: c-A C a Q` Print Name: 70
Licensed Drain Layer
Date:
Standard forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: l / d
BUILDING ADDRESS
STREET
SUBDIVISION:
NORTH RROW
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CONTRACTOR (PRINT) NAME OF C TRACTOR'S SUPERVISOR (PRINT)
Al 7
STREEM�SS'"
SIGNA
DATE
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TOWN STATE ZIP INSPECTED BY TOWN
2 / ? DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER