HomeMy WebLinkAboutDrain Layers Permit 21 Welles Lane (3) Permit No. 6694 Town of South Windsor, CT
Permit Date 09/23/1997 Drain Layer Permit
Expiration Date 10/23/1997
Descrip: LATERAL OFF MAIN IN AVERY ST TO PROPERTY LINE
Applicant Location
Name SIMSCROFT ECHO FARMS Add.r. 21 WELLES LANE
Addr. P.O. BOX 581 Qwner "MAN'NARINO BLDRS
SIMSBURY CT 06070
Phone No. (860 )651-0231 i
The Drain Layer assigried 'thf'i pert it" has a1;;t 1`icense issued by the
state and hereby agrees to, all" the" terms and `eonditio s set forth in the
attached 'Conditions' . A1l,`"work shall ..be In accordanceiwith Town of South
Windsor standards, all OSHA requirements, and th4' attached conditions .
Issued BY ' '�"' r l T-ttle Z -2
Date Inspected"�__ _mod _ Inspected" By �� s��" - ---
TOWN OF SOUTH WINDSOR INSPECTION REPORT
>ermit No. 6694 Contractor SIMSCROFT ECHO FARMS
.ocation 21 WELLES LANE Address P.O. BOX 581
'ype Work NEW SAN LAT SIMSBURY CT 06070
Phone _No. (860)651-023 V
)ate Insp Needed Date" Insp. JS
Insp Needed �'ime Insp;
:nspected By
cork in Progress
hnpu �-o-e? Date
APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR 14�
PUBLIC WORKS DEPARTMENT !J
TOWN HALL f�
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work �/ r A --Iry�o Lot #
Street No. Street Name
Premises owned by:
Name of Firm: Cry�� coo .4r•«S -.L e.Phone: g 6 0 G S-B 3 G 7 6
Address of Firm: G 130� J�81 C C O ?p
TYPE OF WORK.
Lay House Drain Repair House Drain ;
Lay Main Lay Lateral for Commercial/Industrial
Building of acres -Y� 7-0
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 1 :Q� the holder of Drain
layer's License No. 60 20 9 Only holders of Pl, 7 & 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 Conn.DOT Permit No.
Signed: Print Name,I :G f
Licensed Drain Layer
Date: �r 2 -'