HomeMy WebLinkAboutDrain Layers Permit 10 Robins Wood NEW
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 77,39 Cq,_tT'actq�t P&T CO"'S-T;RUCTION CO. , INC.
Location gyp' 1 WMD WAY 'zd, r 655 ,O7ELX 5£REET
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Permit No. 7739 Town of South Windsor, CT
Permit Date 04/26/2004 Drain Layer Permit
Expiration Date 05/26/2004
Descrip: INSTALL SEWER LATER. ; y"
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Applicant ;
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P&T CONST RUCTIName ON C� .. , OF$I " f"
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Addr. 655 LOVELY STRERT l'+�+ter MARTII....BI3<$ :. & ISA B
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state and hereby a're�g' :.o<?'-: .>.>the"'` erfns """t`9.,. and"'c'c�Mt .: Q.k. '' e.. forth in the
attached 'Conditions; :. �11I''"yrC } `"s"kY <: :` >k::a;:C S.i'darice" vi,th �6wn of South
Windsor standards, all OSHA xEuiri}kC�� the atachex�;:cci'nditions.
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APPLICATION FOR DRAIN LAYER PERMIT
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TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work:_ i o a�,,ma's UU-"aa o LA-/A.r Lot #
Street No. Street Name
Premises owned by: '\2S LLA 'L L I s A M
Name of Firm.-' 4. Phone: 7 3 -*a4--
Address:of Finn:_ 6,S7 S L a s
TYPE OF WORK:
Lay House Drain ; Repair__; Repair House Drain
Lay Main _ '
Lay:Lateral for Commercial/Industrial
Building of acres
Connection will be made with _ S 'D Z - 3_s
Existing Water Supply: Public Water__ Well
Proposed Start Gate M A-r 3 Estimated dine for completion 'PAYS ,
ALL WORK-TO BE IN ACCORDANCE WITHTOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit-is to be issued to 77 e, j; ��, ��L A,< the holder of Drain
Layer's License No.ae�5g_g1,g- 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. 00 4gc) l qq I
Signed:-" Print Name:_ I ,moo;-H M.
Lice Drain Layer
Date:_ AT
Standard Forms\PermitSWPLI=0N FOR DRAIN LAYERS PERMN.doc