HomeMy WebLinkAboutDrain Layers Permit 1257 John Fitch Boul 800027 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 06/19/08 >E'
.GIS ID:47701257 '``
w...-~� FEE: 60.00
MUNIS APPLICATION# 200800917
EXPIRATION DATE: 07/19/08
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APPLI CA NT
NAME: CK CONSTRUCTION `"'A ` .
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, DDR�SS Y2571,01IN FITCH BLVD
ADDRESS: 82 NILES ROAD h
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CRIPTION:
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THE DRAIN LAYER ASSIGNED TO THIS PERMIT HAS?A`Y:.s `, `' : "q";° >h I �° sUEII7 E Y;: H ;:STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTTI IN AO` .,w: 5 :L W6,
:SHALL BE IN ACCORDANCE WITH
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THE TOWN OF SOUTH WINDSOR STANDARb' "All,Ch A'RE T�&I-AND'TH 'APTACHED CONDITIONS.
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ISSUED BY DATENSPE'CTED INSPECTED BY
6/19/2008 9:54 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: cr)oo _l CONTRACTOR:
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LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: 9b
WORK IN
PROGRESS: (ah-71 0,9 . ry„ ��.�1'oT c x t4dt.i (0 11 c. sDQ35
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AS-BUILT:
INPUT: Lam- DATE:_ 7
W/2007 Town of South Windsor INPSEMON REPORT 07
le�r� i 1 Tj 41C- ✓
p l oZOa80O9�� APPLICATION FOR DRAIN LAYER PERMIT
l TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT
FEE $60.00
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Location of proposed work:0 -7 h14 r/?t) I t #
Street No. Street Name`
Premises owned by: r hr75ft2 �S
Name of Firm: Phone:
Address of Firm:
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
B ildin of cres
� rec !Y/SiYI ,G �' e�p �u,y, z' Sla �v
v
2.. . #6 Jabs ti r-
Connection will be ma
de with
Existing Water Supply: Public Water Well
Proposed Start Date ' S'- 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 the holder of Drain
Layer's License No. _ffyp 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 and attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD NOC2W !J �
Signed:ZE Print Name:
Licensed Drain Layer
Dater
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMFr.doc :::
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1540 SULLIVAN AVENUE SOUTH WINDSOR, CONN. 06074
soe•0)" AREA CODE 860/644-2511
SEWER TEST REPORT
PROJECT: To�A Fi Pa,y' 6 e s L L e f /
LOCATION: 1 ,2 q q Z
DATE: a
MANHOLE NO. ITEST PRESSURE (PSI) TEST TIME RESULTS
OR STATION ISTART ISTOP DROP ' START ISTOP ITIME
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TESTED BY: K �°� `''"�`�"y^1 � �;r�o f es-1
INSPECTED BY:
REMARKS: q '' �VG sCtt Rb FI-6
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