HomeMy WebLinkAboutDrain Layers Permit 188 Wheeler Road PWm>st%No. 7460
Permit Date 07/10/2002 Town of _South Windsor, CT Expiration Date 08/09/2002 Drain Layer Permit
Descrip:
Applicant "" Location
Name CEZARY T. PLANNER
Addr. 42 HIGH RIDGE DRIVE 4 8 WHEELER ROAD
A R AND LUCYNA KEBALO
NEWINGTON CT _ I'
Phone No. (860)983-6552
The Drain Layer a s s as cense issued by the
state and hereby agr - e r nd i s set forth in the
Windsor standards, al q a with Town of South
attached 'Conditions' . 1 r
ched conditions.
Issued By
Date Inspected 0 e y
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7460 Contractor CEZARY T. PLANNER I
Location 1,88 WHEELER �ROAD ,- Address 42 HIGH RIDGE DRIVE
Type Work NEW SAN LAT NEWINGTON CT 06111
No. (860)983-6552
Date Insp Needed Is D/0.;%-
Time I nsp Needed 1 f Pi✓�
Inspected By
Work in Progress
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: '2- 10 O Z
BUILDING ADDRESS
STREET
SUBDIVISION:
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CONTRACTOR (PRINT) NAME OF CO RACTOR'S SUPERS INT)
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STREET ADDRESS SIGN Ai-TURE
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NJ DATE
TOWN STATE ZIP INSPECTED BY TOWN
F60 �5J~2 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
-740 �
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: 8 VJ H AL 00 - Lot #
Street No. Street Name
Premises owned by: � LToL ILL) 0 0A IL
Name of Firm: P L-A-dti'E� Phone:
Address of Firm: AZ *qik- !?fa�_ oew I�J G00
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water ✓ Well
Proposed Start Date 7 /n p Z 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 Qthe holder of Drain
Layer's License No. 20 � . Only holders of P1 or P7 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.
CBYD No.
Signed: Print Name:
17 Lice Dr An Layer
Date: 1l d 2-
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc