HomeMy WebLinkAboutDrain Layers Permit 55 Wentworth Drive b
Perrrf+t- No. 7388
Permit- Date 02/08/2002 Town of South Windsor, CT
Expiration Date 03/10/2002 Drain Layer Permit
Descrip : _
Applicant
Location
Name ROTO ROOTER `Addy 0055 WENTWORTH DRIVE
Addr. 15 BARBER POND ROAD Qw,ner WHITE ROBERT G+LINDA C SURV
BLOOMFIELD CT 060012 ,F
Phone No. (860 )727--9500
The Drain Layer assghee this pe �mit etas a _valid icense issued b the
state and hereby agrees 'tt�.°�7Y the -terms and con itiors set forth in theattached 'Conditions ' r� =A� t ��;�+tfl�'k'. �;#��� l be �� �dec�,r�lanc� with Town of South
Windsor standards, ail (3SHA requirements, and attached conditions,
Issued By
Date Inspected _Z U� �2- Inspected By
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7388 Contractor ROTO ROOTER
Location 0055 -WENTWORTH -DRIVE Address 15 BARBER POND ROAD
Type Work RPR SAN LAT BLOOMFIELD CT 06002
Phone;_No. (860 )727-9500
Date Insp Needed 02 Date Insp Z
Time Insp Needed Time Insp.
Inspected By
Work in Progress
Input Date
~ TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 2-Z° F�LC9
BUILDING ADDRESS
STREET 7w
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME 0 CONTRACTOR'S PERVISOR (PRINT)
STREET ADDRESS SI ,A,TURREE
`y `� �'�`�Z DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
738�
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: . ���,� �.G� ��_ Lot #
Street No. Street Name
Premises owned
Name of Firm: Ao' �/cJ 49,0 ,— Phone:—a
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
Proposed Start Date �40 2- Estimated time for completion _3
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 the holder of Drain
Layer's License No./,"-/-:2o3Zd r 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: Print Name:
Licensed Drain ayes
Date: g
Standard FormsTermits\APPLICATION FOR DRAIN LAYERS PERMIT.doc