HomeMy WebLinkAboutDrain Layers Permit 12 Robins Way TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7102 Contractor DEBRIKO/BRIAN KOCHER D/B/A
Location 12 ROBIN'S WOOD WAY Address 50 ELM STREET
Type Work NEW SAN LAT VERNON CT 06066
Phone, No. (860)870-9746
Date I nsp Needed I nsp;.
-t
Time Insp Needed lnsEp.
Inspected By
Work in Progress
Input Date
PerTjt No. 7102 Town of South Windsor , CT
Permit Date 12/08/ 1999 Drain Layer Permit
Expiration Date 01/07/2000
Descrip:
Applicant Location
Name DEBRIKO/BRIAN KOCHER D/:g/A: ' Addr.; 12 ROBIN' S WOOD WAY
Addr. 50 ELM STREET Owner JAN'_,LUKASIK
{X t
VERNON CT6QJ
Phone No. (860)870-9746 '
The Drain Layer a�s'igr#ee t►�is pel"*- tryhas � v� I ,I J cense issued by the
state and hereby agraes tb 11 the ` r ,and cmJ d-pions set forth in the
attached Conditions' . Al wtt k s r l s pa �i n a o "don.ce with Town of South
Windsor standards, a 17 'OSAe�lti tm®1i.t end the attached cond i t i ons.
M .
Issued By J Tft.
Date Inspected Inspettci .By
10�
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE G z-
SOUTH WINDSOR, CT
FEE $25.001
Location of proposed work: - Lot #
Street No. Street Name
Premises owned by: c�
Name of Firm:— � �D Phone:' S" 75�a
Address of Firm: a, n
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 5 Z
Proposed Start Date Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,,__
ALL""-OSHA-REQUIREhIENT AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to�� 2f KD th holder of Drain
Layer's License No. ®6 2 13 � Only holders of P1, 8c 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 sgk forth in
the permit and attached'thereto. Applicant has received Town Street Evation
Permit No. and/or ConnDOT Permit No.
Signed:f � 411'Q4,24JL--t— Print Name: �/?/y,4/?-/-)
Licensed Drain Layer
Date: 12,
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc