HomeMy WebLinkAboutDrain Layers Permit 5 Steep Road i
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7909 Contr>�- --J-A-'&Z THROWE
Location 0005 STEEP ROAD Rdi resa k VA tea.S Y R & SEPTIC
Type Work NEW SAN LAT H` r`":y97' RS, .DE`'°RRIVE
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Permit No. 7909 Town of South Windsor, CT
Permit Date 04/26/2005 Drain Layer Permit 1
Expiration Date 05/26/2005
Descrip: INSTALL SEWER LATERA4--'
Applicant ' ,'_ ..' yr,. `4. Lo' : tion
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Name JAMES THROWE � � 400 sx�:E RO II:
Addr. VANS SEWER & SEI�TF<' r ' a:<: `. }Y s1sR1� .7OS` � L> & RHONDA L
97 RIVERSIDE DIVEh.
� � ter, 3yya
VERNON
Phone No. (860)289 0:0,9'53, f'" 8
Y
The Drain Lay ass:ies�l Rigis fiYalid�3cznse >sued by the
state and hereby aee t � hwsr YdT� t ,o � set'.',£oth in the
attached 'Conditio S Ak��, io shall ber in accort� wiC Toown of South
�YGMIA h d coiditions.
Windsor standards, �1'1 0SKA,1 e ire �tYae. fi t'.
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Issued By y^ ' r'--s�.�/�1--.— -------------------
Date Inspected
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TOWN OF SOUTH ANDSOR
SANITARY - SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: XXZ4�k
BUILDING ADDRESS �� �
STREET
SUBDIVISION:
NORTH ARRflWQ'�(
RIO
Mol
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CONTRACTOR (PRINT) NAME OF CONK RAC OR'S SUPERVISOR (PRINT)
STREET ADDRESS TURE
cl o 64 � o TE
TOWN STATE ZIP INSPECTED BY TOWN
lib t-(A-s- DATE
TELEPHONE-NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
P7 9o9
APPLICATION FOR DRAIN LAYER PERMIT
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TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: �� Lot #
Street No. Street Name
r
Premises owned by: ,t�
Name of Firm: Phone:
Address.of Firm:_�7 (`�+�c�'; ; C�.,2_ ��,� . .�
TYPE OF WORK:
Lay House Drain ' ; Repair House Drain
Lay Main '
• Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with o%:)
Existing Water Supply: Public Water Well
Proposed Start Date Estimated time for C completion �
P S
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 13('i' I's kcL,AA— the holder of Drain
Layer's License No. vr�< Only holders of P-1, P-7 or W-9 licenses
will be issued a pen-nit. 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: �.�-,,.,►-- ' -
�"'�^-'' Print Name:--�c��h � ) hr
v'
Licensed Drain Layer
Date: 2 C
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr.doc