HomeMy WebLinkAboutDrain Layers Permit 35 Summerwood Lane ,owU OF SOUTH w.w°s°R INSPECTION REPORT
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1.11nd BY
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: I ' I3` 06
BUILDING ADDRESS : I n" '"" —7 3 5
STREET Su N+,m �a A,woA lQ
SUBDIVISION: SGInl a/. W Elk
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CONTR C R (PRINT) NAME OF WNiRACTOR'S SUPERldOR (PRIM)
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STREET MORESS .1. SIGNATURE
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TONN STATE SIP INSPECTED BY TOWN
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TELEPHONE NUMBER
OR - WNN PINK - CONR2ACTOR YEIIAW - CONSULTING ENGINEER / )E PER
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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 $60.00
LocaUon of proposed work: �.S �' - i . Lot # 7
Street No. Street Name .
Premises owned by: o^s �(4 Lw+'�s _
NameofFirm: n(2 C�2 ,� //n< _Phwr; 075{'
Address of Firm: 7 0 �1� a F C}
TYPE OF WORK / -
Lay House Drain ✓ Repair House Dram
Lay Main Lay:Lat are rfor CommZ'al/Indust ial .
Bunamg of_ aces
Connection Will be made with 6 ° b L.
&Isting Water Supply: )��Publi�c Water Well
Proposed Start Date_Ll(.Z10'e Estimated time for completion
ALL WORK TO BE INACCORDANCE WITH TOWNOF SOUTH WIND STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be Issued to �-( [y �y the holder of Drain
LayeYs License No. y . Only 1022of P-1,
Will be issued a permit. PERM WIL—L EXPIRE THIRTY (30)1)AYS AFTER saS
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terns '-and conditions set forth in the permit and attached thereto. Applicant has received
Town Sheet Ekeavation Permit No. and/or ConnDOT Permit No.
CBYD No. A
Signed: Print Name:
U Layer
Date: G�
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