HomeMy WebLinkAboutDrain Layers Permit 301/302 Wentworth Pa Permit No. 7946 Town of South Windsor, CT
Permit Date 07/14/2005
Drain Layer Permit
Expiration Date 08/13/2005
Descrip: INSTALL SANI
TARY LAT'�RAL`"'
Applicant r'` t :::. 'X
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Name J & H SLATER CONuT'CO ¢� Q1/302 :WfTWCRII PARK
Addr. 75 COMMERCE WAY, fN '
v :er GENERA.T .pN:
SOUTH WINDSOR C,TO6074
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Phone No (860)528-5.25.
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7946 C_ iYtra+ctp:,r'J Ate:'H YLA'P R CONST CO
Location 301./302 WZNTWORt R PARK ' "
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Type Work NEW SAN LAT *:-x
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL:, FIELD LOCATION
DATE OF CONSTRUCTION:
.BUILDING `ADDRESS 30t - 30 6 o4kz
STREET
SUBDIVISION: U�eh,1.��rt'h day
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CONTRACTOR (PRINT) NAME OF CON CTOR'S SUPERVISOR (PRINT)
" a iwxv &mac� ��
STREET ADDRESS SIGNATURE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
794-6
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: # �d1 �6z
Street No. Street Name
Premises owned
Name of Firm: 4T Czusr U Phone:
Address of Firm:
TYPE OF WORK:
Lay House Drain_; Repair House Drain
Lay Main - ; Lay Lateral-for Commercial/Industrial
Building of acres
Connection will be made with k flu C
Existing Water Supply: Public Water X Well
Proposed Start Date 1 S 0,!�' Estimated time for completion _ U�
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 _J ,LA , c TESL the holder of Drain
Layer's License No. ?s's"I? 0'i Only holders of P-1, P-7 or W-9 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 an4 attached thereto. Applicant has received
Town Street Excavation Permit No. �J and/or ConnDOT Permit No.
CBYD
Sign Print Name:_JNMtS VJ. t�
Licensed Drain Layer
Date: b�
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc