HomeMy WebLinkAboutDrain Layers Permit 1201 Strong Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7230 Contractor SKIPS SEPTIC
Location 1201 STRONG ROAD Address 27 MUDDY BROOK ROAD
Type Work NEW SAN LAT ELLINGTON CT 06029
Phone No. (860)875-2332
Date Insp Needed �� 2� Y1 i >�'°L �" Date Insp. 1-7-1-7- /600
Time Insp Needed Ti me, Itsp,,
Inspected By ��1�-��`
AiWiAl ;'71 bl.0
Work in Progress • `
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Inpu Date / Let
P-7r -5 0. 7230 Town of South Windsor,
Pefmi bate 12/22!2000 Drain Layer Permiir
" E freition Date 01 /21 /2001 t'
Descrip:
Applicant Location
Name SKIPS SEPTIC 'Addr. 1201 STRONG ROAD
Addr. 27 MUDDY BROOK ROAD =owner, RAYMOND ALFREDA S
ELLINGTON CT Qb029 .
. Phone No. (860)875-2332
The Drain Layer a i gted t.h i s, �armi t his a :'val i c license issued by the
state and hereby ao-rees' ,to ani 1 th'e ,ter a's find - aand ti ons set forth in the
attached_ 'Condition o r# , sh `� be i n a ord' ce with Town of South
Windsor. standards, 11 E3SH!4 requiremts, and =-th attached conditions.
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Date Inspected /:2 0746 00 ;By
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TOWN OF SOUTH WINDSOR
SANITARY- SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: /2 &o 0Jr
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BUILDING ADDRESS —/.Z0 i MAoAl c
STREET
SUBDIVISION:
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S VISOR RINT)
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STREET ADDRESS SIGNATURE
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TOWN STATE ZIP INSPECTED BY TOWN
S?,!r 23 3rl- DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work: /Z®/ 517K oAj G F-D Lot #
Street No. Street Name
Premises owned by: �����'� �19Y Me'Aj ?S
Name of Firm: s�,PS S'��'ri C— Phone: '?7S- Z-33-2—
Address of Firm: 2-7 A 44-)j-)y �7L oo,- X D C.�4 1N G mkl
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with PVC Y.Pk 3 -5'—
Existing Water Supply: Public Water Well >4,
Proposed Start Date it- f7 loo Estimated time for completion �2Z
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 —7a74 G�)gkkg,-- the holder of Drain
Layer's License No. ze '7 71- f . Only holders of P1 or P7 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.
e-
Sign : Print Name: %Wh®�S -1u k kCir
L censed rain Laye
Date: 1Z--2z r00
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr.doc