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HomeMy WebLinkAboutDrain Layers Permit 190 Pleasant Valley TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 7082 Contractor H. W. LEVACK CO. Location 0190 PLEASANT VALLEY Address 49 MASCOLO ROAD Type Work RPR SAN LAT SOUTH WINDSOR CT 06074 Phone No. (860)528-0131 Date Insp Needed will CAI[;-" :' Date "IM, �� Time Insp Needed Inspected By P� 3 Work in Progress &,"� : T c, 5-�c�b e©sin�"TIJfPf� m�i -re �'i�" (�ARu 11.• 1 c.K�.0 aiws" c P--ccN fi f f9PA14L> A►,x� G(7EA�-o�T �c�BMrt"f� aw rE�1��9� Input, Date lilt Per It No 7082 Town of South Windsor, CT -Permit Date 11/08/1999 Drain Layer Permit Expiration Date 12/08/ 1999 ,Des1p: REPAIR SEWER LATERAL Applicant Location Name H. W. "`LEVACK CO. 0190 PLEASANT VALLEY ',Addr. 49 MASCOLO ROAD DEZELON DENNIS R + SOUTH WINDSOR CT 0607=4 Phone No. (860)°528-0131 The Drain Layer as1';gnd' th1s Sri `is 'a ua1�d T,icense issued by the state and hereby agrge` o , 71th t ent ttr#? i ohs set forth in the attached 'Conditions' :-Ai1 Work in -dance with Town of South Windsor standards, alai" OSHA, j*jqu7rn °; and tEittched conditions. Issued By i Date Inspectedspctd icy - { 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: of # Street o. Street Name T Premises owned by: � Name of Firm: /-Z- � f/j -� Phone:S2 - z�,)? Address of Firm: TYPE OF WORK: Lay House Drain ; Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with Proposed Start Date 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 the holder of Drain Layer's License Noce--) 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. Signed: Print Name:`�� � Licensed Drain Layer Date: Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc _ House #19 d AR 1 TF= 43.0 \ ,• 11LF OF W'V.T.LAT. 6 CLAY PIPE oeEQ ui tSLF OF 6"VT LAT ( I 0EEP _ —� C.B. INV= 38.72 WR SEcJFfz ntin� 4ftI Ah30a5 cr 6 _ U H Q TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: _ BUILDING ADDRESS PIV -� STREET SUBDIVISION: NORTH ARROW "7i 147 j f -r__ __ - r I = _4_-- CTOR (PRINT) NXMt OF CONTRACTORj SUPERVISO (PRINT) DDRESS SI NATU ll )a DATE STATE ZIP INSPEC TOWN DATE BER PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER