HomeMy WebLinkAboutDrain Layers Permit 55 Sele Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6787 Contractor JEFF VULL.O I-RUCKING fx EXC . INC
Location 0055 SELE DRIVE Address 167 MILLER RD
Type Work NEW SAN LAT COLCHESTER CT 06415
Phone No. (860)537-1974
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Permit NO. 6787 Town of South Windsor , CT
Permit Date 04/15/1998 Drain Layer Permit
Expiration Date 05/15/ 1998
Descrip:
App i i C;cAr"tT. i_c]C-;at i on
Name JEFF , IPUCPAN(.; & r-xt; , ItaiC. A .3cjr ` C�,ubb LbRIvk:
Addr . 167 MILLER RU rrri"er` # ALDtr LILA. B
COLCHESTER f Uti4 15 `
Phone No. ( 860 )537-1974
The Drain Layer assigned this permit has a Va1;1d' license issued by the
state and hereby agrees t6 aI I the terlo acid con4vt1ons uet forth in the
attached ' Cored i t i ons ` A! I;,,-w ri: °'ehATl ,die i`n ac or dance with 'mown of South
Windsor st nda ds, a I 1 i�SHA r'equ i cements, arid,, i;te .ttta.c;hed cond i t i one .
Issued By ,/_
Date Inspected I»SpeCted / �`
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET Lo. ,�P V e Dc ' v
+ SUBDIVISION:
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CONTRACTOR (PRINT) NA OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIG ATURE
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TOWN , STATE ZIP INSPECTED BY TOWN
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TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER
APPLICATION FOR DRAIN LAYERS PERMIT
y� TOWN OF SOUTH WIlYDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: r'(� { L' Lot #
Street No. Street Name
Premises owned by: Ora c--i c,4'
� �' Phone:
Name of Firm: �-�� -a—
Address of Firm: 7 �-L!
TYPE OF WORK:
Lay House Drain_ Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Proposed Start Date 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 �/ l the holder of Drain
layer's License No. r>r>•?-0 Only holders of P1, 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: Print Name
Licensed Drain Layer
Date: i�