HomeMy WebLinkAboutDrain Layers Permit 63 Wedgewood Lane Permit.No. 6995 Town of South Windsor, CT
Pel-mi*t Date 06/04/1999 Drain Layer Permit
Expiration Date 07/04/1999
Descrip: $25 .00 CASH/$195 . 00 CHECK
Applicant _- Location
Name YANCEY Adtr Ob 3 WEDGEWOOD LANE
Addr.. 27 R COMMERCE STREET BEY DOUGLAS & CYNTHIA (SURV)
GLASTONBURY CT g `
Phone No. (860)633-0423
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The Drain Layer ass gr i t�h. s� ► r� has <''� d.-1 cense issued by the
state and hereby agree a; t e end ins set forth in the
attached Conditions . Al ` k sal ern a4)p in w i th Town of South
Windsor standards , all
OS tAched conditions.
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Issued By
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6995 Contractor YANCEY
Location 0063 WEDGEWOOD LANE Address 27 R COMMERCE STREET
Type Work NEW SAN LAT GLASTONBURY CT 06033
Phon ,,No. (860)633-0423
Date Insp Neededfr�
Time Insp Needed I'nsp
Inspected BY a^_ G $
Work in Progress i•' S' � � ,a
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inAA Date _1T c B5
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: (!�, &AMnr. Lot # .1
Street No. Street Name
Premises owned by: /V►-
Name of Firm; rX Phone: O 3
Address of Firm:-,p? 2 rre rSn �u r to
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 6 fi
Proposed Start Date��V1,*f Estimated time for completiont: i
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 K the holder of Drain
Layer's License No. .2 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:9 Print Name:
Licens Drai er
Date: y
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH' WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: G/ g�-
BUILDING ADDRESS
STREET
-F- SUBDIVISION:
NORTH ARROW
i 1
1
IPA
1
:
1 � f f 1
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VCAVILe'vI
CONTRA TOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SCRATURE
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TOWN STATE ZIP INSPECTED BY TAN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER