HomeMy WebLinkAboutDrain Layers Permit 165 Rosemary Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6880 Contractor RI-CHE CONCRETE CONST.
Location 0165 ROSEMARY LANE Address RICHARD CHENEY D/B/A
Type Work NEW SAN LAT 42 OAK DR t�
MANSFIELD CENTER CT 06250
Phone;, Np:r, (860)423-1450
Date Ins Needed 9� 11
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Permit No. 6880 Town of South Windsor, CT
Permit Date 09/22/1998 Drain Layer Permit
Expiration Date 10/22/1998
Descrip: PRO-RATE USER FEE PAID-$48. 75
Applicant Location
Name RI-CHE CONCRETE CONST. � Ac ¢r,. 0165=.ROSEMARY LANE
Addr. RICHARD CHENEY D/B/A bwnert'PRT:CE,`'KIMBERLY A ,
42 OAK DR
MANSFIELD CENT CT �06250 '
Phone No. (860)423-1450 . .
The Drain Layer as6i gned thi s permit -has a va fi
ci 1$i ense issued by the
state and hereby agrees,,to all the ta.rma fi nd cone aiti ona set forth in the
attached 'Conditions' .' A11�,w®rtk shy>11 b� n .acborince with Town of South
Windsor standards, all OSHA requirem nts, anal, the` attached conditions.
Issued By 'floe,
)ate Inspected 4 Inspected'" By ����.-
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: l�
BUILDING ADDRESS �S 1P �
STREET
+ SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF 0 TRACTOR'S PERVISOR (PRINT)
STREET ADDRESS SI NATURE
Ala.# ��'' VP ` � 1 ATE
TOWN t� STATE ZIP INSPECTED BY TOWN
Ad 1.7- ��7�� DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
APPLICATION FOR DRAIN LAYERS PERMITd
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work e'~V y Owl Lot #
Street No. Street Name
Premises owned by:
Name of Firm: Phone: �V3-7�W
Address of Firm: 4- A4,,dey
TYPE OF WORK. /
Lay House Drain Repair House Drain
,
Lay Main ; Lay Lateral for CommerciaVIndustrial
Building of acres
Connection will be made with
Proposed Start Date Estimated time for completion 2 e,1e .r
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 the holder of Drain
layer's License No Only holders of Pl, 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. LLZo Print Name Jo-s -
Ltzensed Drain Layer
Date: 02 ��