HomeMy WebLinkAboutDrain Layers Permit 178 Abbe Road (2) TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:_Q20_s CONTRACTOR: m 0
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DATE INSP NEEDED: Tom"
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W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
�pp1 Sal 1�� PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: Ne-, Lot
Street No. Street Name
Premises owned by: J-e
Name of Firm: i �aww5 Phone:g/6'6s;�'�6Z6
Address of Firm: PC, � � ►,, -
TYPE OF WORK:
Lay House Dram ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with SC LV S
Existing Water Supply: Public Water V Well
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 Gti c the holder of Drain
Layer's License No. 010•d —ye 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 No. 200 9 36a
Signed: Print Name:"
Licensed Drain er
Dater 36
StarStiard:Forms\Permits\APPLICATION FOR DRAIN-LAYERS PERMIT.doc
TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERALFIELD..; LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS 1
STREET A L OAL�
SUBDIVISION:
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CONTRACTOR (PRINT) _ NAME 0 CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS. G RE
. W� DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW = CONSULTING ENGINEER / DEVELOPER
800038 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
;
DATE: 07/30/08
GIS ID: 00600178
FEE: 60.00
MUNIS APPLICATION# 200801154 < "& 7 "'+ EXPIRATION r ., ' ` IRATION DATE: 08/29/08 1
f.y.::y.
APPLICANT �% ' " LOCATION
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NAME: SIMSCROFT ECHO k�ARMS, ff f ADDRESS 378 ABBE ROAD
ADDRESS: P O BOX 581 M NR PRRA JACQUE R&LORI JAYE D
SIMSBURY CT 060f 0
3 , r «- J'?8 ABBE ROAD
V,sF. KQ,UTV INDSOR,CT 06074
PHONE 860-651-0231 ry
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WORK DESCRIPTION: RELOCAT E Y '
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HE DRAIN LAYER ASSIGNED TO THIS PER IT 1'.1 S"A?y j 1j T,I.,E: :, IT`S"LTFj Y-THE, TAT E AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOI&H TT AT 1 1 G(Q IO '"AC WOik SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDA DSy A I"f�SHA.� hI 18"'A?I$a T1 E ATTACHED CONDITIONS.
ISSUED BY DA E INSPECTED INSPECTED BY
7/30/2008 9:48 AM
INSPECTED BY: I
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W/2007 Town of South Windsor INPSECION REPORT 07