HomeMy WebLinkAboutDrain Layers Permit 479 Pleasant Valley } ' TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7873 Contratar''B � rbA<CONSTRUCTION
Location 0479 PLEASANT VALLEY A d`resg. a,r .¢P.04..kBO, ..
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Type Work NEW SAN LAT . 105f
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Permit No. 7873 Town of South Windsor, CT
Permit Date 12/16/2004 w, Drain Layer Permit
Expiration Date 01/15/2005
Descrip: CK 3554 BIELLA $60.005' C 'a(i'4 Uf@PAT±:E-. E1 DE i` ,RS $1038.00
ApplicantPC. li'gat.ion
Name BIELLA CONSTRUCT .f3' + •'", 17.2 ;1�521SAI: ' IM.
ALEY
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Addr. P.O. BOX 311085 <:wo;ri�er ORDWA ',IiENIt'Y
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NEWINGTON
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Phone No. (860)233-4 ";oiy,
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4'33`)
The Drain Layer ��: h.�d � "i;Y�' ' �'h �.�<��Z'"`lid �<x` eri 'e.,.iss�ied b the
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state and hereby agYee.&s.to7 ,»tti fira"s'':a4i'ci�Fet3> t taol�5s:et` fd3�,th in the
attached 'Condition&,'<,�,A 11� 4 ..>.Y k e a e.Y_:4u th''-o. n of South
Windsor standards, all OSHA::' �' '� `
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Issued By � >+, T< t l -----------------
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Date Inspected Inpe: tY'�y
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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
Location of proposed work: V 9 L N }r VAI I gp,Lot #
Street No. Street Name
Premises owned by: NE-le/A/eRy ®PP (dA\
Name of Firm: ,�I�LL�4 C'�!u S T� Phone: A* AWZ331106
Address of Firm: j 3 SPAIA16 .91' &8y1iv6,roN C61vV
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 A-RVe, BZAE
Existing Water Supply: Public Water Well 1�
Proposed Start Date /2-17 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 tG13�2T IG the holder of Drain
Layer's License No. '2 01 ?t� Only holders o =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. I 24r i 14 12 do q'W70 3a*S`
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Signed: Print Name: A06k T )EL LA
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:
BUILDING ADDRESS �`�`5AI'I` IrA�Y
STREET
SUBDIVISION:
NORTH ARROW
159
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CONTRACTOR (PRINT) s NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
L?o OFaT �ltl-'-A �
14 STREET ADDRESS SIGNATURE
ATE
TOWN STATE ZIP INSPECTED BY TOWN
/VNtt/i/I/ :TCN C G'�✓11J Cry'/r� DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER