HomeMy WebLinkAboutDrain Layers Permit 240 Pleasant Valley r
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7169 Contractor SKIPS SEPTIC
Location 0240 PLEASANT VALLEY Address 27 MUDDY BROOK ROAD
Type Work NEW SAN LAT ELLINGTON CT 06029
Phone. No. (860)875-2332
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Work in Progress .
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Input Date 7-7,5-ay
Per , I No. 7169 Town of South Windsor, CT
P%+ i.t Date 07/18/2000 Drain Layer Permit
Expiration Date 08/17/2000
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Applicant cation
Name SKIPS SEPTIC ` Addr., 'j0a PLEASANT VALLEY
Addr. 27 MUDDY BROOK ROAD One T EDWARD S JANE H
ELLINGTON CT job
Phone No. (860)875-2332 "
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The Drain Layer a `en�rd nth s per�ri t has a val i tf license issued by the
state and hereby agree s 1 t and a lit7phs set forth in the
attached 'Conditions Al ;trk shaI in ap �rdanps with Town of South
Windsor standards, a 11 CSFFI ►"�cu�rents, ;and irhe attached conditions.
Issued By ; I"itl
Date I nspec d � lid �`�Tnspe ed By
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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 $25.00
Location of proposed work: ,�4o ?I-c4544-r Ufikk�y Lot #
Street No. Street Name
Premises owned by: E Gu.-rT—
Name of Firm: 6PP 5 Se pnc- 6'.6xvrcL Phone: Uo ??S Z3 3 Z.
Address of Firm: 27 /U u�p�Y g7gob k 7cD C,
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 6" PVC,
Existing Water Supply: Public Water Well
Proposed Start Date 7 1�O-00 Estimated time for completion 7 Z/- 0 0
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 -16V-1 W 4LkEA- the holder of Drain
Layer's License No. •Zo 7 7 z 5' . Only holders of P1 or P7 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, �ooa '3000
Signe Print Name: A-S 6)'44kellr- V/t-
icensed Drain 4Layy
Date: da
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr.doc
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SANITARY SE E-ATERAL f two LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS 9 d kcZ-AW-7 U A-U-4,' 'Z O.
STREET
SUBDIVISION:
NORTH ARROW
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S'KIpS SgOc 5`11 oc< M ICHEL LA�L6
CONTRACTOR (PRINT) NAME OF C NT CT 'S UPERVISOR (PRINT)
STREET ADDRESS ( SIGNATUR
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TOWN
STATE ZIP INSPECTED BY OW
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER