HomeMy WebLinkAboutDrain Layers Permit 660 Rye Street TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7716 Contra'otor COTA `CtONSTRUCTION, LLC
Location 0660 RYE STREET A'ddre.s: P p.- OX' =242`">
Type Work NEW SAN LAT
RF�QD $RGQK .CT"0,6016
Phone No 292 6104
Date Insp Needed ------------- Date Trisp �
Time Insp Needed Time------------
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Inspected By
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Permit No. 7716 Town of South Windsor, CT
Permit Date 03/17/2004 ""` Drain Layer Permit
Expiration Date 04/16/2004
Descrip:
Applicant LSoa.E` .on
iv
Name COTA CONSTRUCTION 3LA: Addy OF6Oyg STREET
Addr. P 0 BOX 242 aYrirler FITZIN ;ERIK ,T & KAREN M
BRAOD BROOK CT 06016
Phone No. (860)292-6104
The Drain Layer assigned thisak has a vl�d license Isstied by the
state and hereby agrees 'to 11' th it ,
e terms Xxi.and condio"' het:::#or:.th in the
attached 'Conditions' . All44
work shTle aoQxdane WYth Town of South
Windsor standards, all OSHA rejuiremnts,- attaohec ,:,conditions.
Issued By t 1 e ----------- -------
Date Inspected
--------------------- Inspp `cted By ---------------------------
TOWN OF - SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: Cy
BUILDING ADDRESS
STREET : ,�'e
SUBDIVISION:
NORTH ARROW
_4Z
CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
" 3 A
TOWN STATE ZIP INSPECTED BY WN
-- (qj 60 ) L Z /o I/ DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
APPLICATION FOR DRAIN LAYER PERMIT -7 1
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: t-Co O S+ree+ Lot #
Street No. Street Name
Premises owned by: Karen �i+z_i n
Name of Firm: Cora Con4rud,on Phone:
883-44�� cell
Address.of Firm: jOX O� ua ART-0c�c1 6r0ok E D i�
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with _ 4-nw e_L0-g_''
Existing Water Supply: Public Water Well
Proposed Start Date,3�;9104-- Estimated time for completion 3 (�
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 &04 CQ+G�_ the holder of Drain
Layer's License No. -7 q 4aa . 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:�e1� �� Print Name: a..
Licensed Drain Layer
Date:
Standard Forms\Permits\APPUCATION FOR DRAIN LAYERS PERMIT:doc