HomeMy WebLinkAboutDrain Layers Permit 960-970 Pleasant Val TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7766 Co„x3t'Yactor COR IA iEXCAVATORS INC
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Town of South Windsor, CT
Permit No. 7766 '" "^`
���" Drain Layer Permit
Permit Date 07/07/2004 ;.;F „5
Expiration Date 08/06/2004 ' =.
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Descrip: INSTALL SEWER MAIN,�fiO,;si ',' "
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to and hereby ag�.e'�,�::t � •;.:�,>:<:a:>x::>;;>:€'-<::>,".€� «y ;,.,..,. . :`.ith.T4wn of South
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Issued BY ------ —------ — —
x^Wawr,r,xe'r..NF+'x:;+e::"lev
Inspected By __ ---
Date Inspected __---__--------
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
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Location of proposed work: 7 0Ue, tot #-'
Street No. Street Name
Premises owned by: �e).96( 0 Gf�u
Name of Firm c � c Phone: s 7^ 2 l S^
Address:of Firm: 7 " 4 y,,gj,1 o o 7aAA ®�� C r 0 C o 3 3
TYPE OF WORK:
-- R Lay House Drain Repair House Drain ;
`Joe y Main `''. ; Lay Lateral for Commercial/Industrial
FBuilding of acres
ade with P �' � S'
ly: Public Water Well
Proposed Start Date !7 1. !/ 4 Estimated time for completion
ALL WORKTO BE IN ACCORDANCE WITH-TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to _ (26 d �� , :,� c the holder of Drain
Layer's License No. ,.2 O 95 i? 6 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. n� (�I° of 8` o- O q g 3
f
Signed: 22 L2 Print Name: 5 z . CIO op R e
Licensed Drain Layer
Date: l —
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc -