HomeMy WebLinkAboutDrain Layers Permit 533 Rye Street TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No.
Contractor.. FOLS.OM "00.NSTRUCTION LLC
Location d.V. � `.138} Y ST2EE
Type Work P NEW SAN LAT
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Permit No. 8135 Town of South Windsor, CT
Permit Date 01/22/2007 Drain Layer Permit
Expiration Date 02/21/2007
Descrip: INSTALL SANITARY SEWER'4LA1 RBv.
Applicant ,r>
Name FOLSOM CONSTRUCTI_QN.yZL�, s>^:t;�:::: ;`' dy�.x,:<�;' �<„.• YE�S`i'kEE`�'
Addr. 138 RYE STREET
r "Euz" rax •OEr_ HOLT GJ;:Lr$.�RI.. I!"
WINDS OR 'C .0 :>b'7!1`
SOUTH 0 T>. 6' <�
Phone No. 860 528 89( )
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The Drain Layer asaz'`'n' 3s""` h." €"3 .d..1- .' rise : .`ued by the
state and hereby
he"`t"e'rms`"'MA''d"cns�i'�fYt. n:`F:<> 't<;:.for: h in the
Y :. ``koar
' ' " oattached 'Conditions�< f South
Windsor standards, all.. OS$A 'cgsz 'r' a i$!}: 'a 13' e att,:e3:kcoz'ditions.
Issued By
Date Inspected --------------------- InsV����'�""By
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TOWN OF SOUTH NINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 64') 01
BUILDING ADDRESS 3 R YE S'tr�
STREET
SUBDIVISION:
NORTH ARROW 6ev as s ae4
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CONTRACTOR (PRINT) N E CONTRACTORS SUPERVISOR (PRINT) °
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STREET ADDRESS _ TURE
oil, cyv ( I p DATE
TOWN 4 STATE ZIP INSPECTED BY TOWN
U 6 6 Z DATE
TELtPHONE 16MRER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER
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: ' 3 /2- cS Lot #
Street No. Street Name
Premises owned by: (S(- e ✓
Name of Firm: YCv-Pt d-)-,-, �dv►s u 6 �Iw7 Phone: &
Address of Firm:_ �� cS�. d� �/��c /fa,� Cr Dl 07 ,/
TYPE OF WORK: /
Lay House Drain L-�; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with ' SDI
Existing Water Supply: Public Water. ✓ Well
Proposed Start Date ( Z 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 the holder of Drain
Layer's License No. 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.
Signed: int Name: Mlli
Lice a rain Layer
Date: / , d 7
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc