HomeMy WebLinkAboutSanitary Lateral Street Cut Permits 21-3 TOWN OF SOUTH WINDSOR INSPECTION REPORT � IJ
Permit VV
$11 Contractor KESSLER'C.ONSTRUCTION CO.
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res 244 PROSPECT E.Type Work N$W': T 1l1I`. a.,, yu
I-��3R,T.FORD E'� a61'0::6
Phoxxe No {86#312$6
Date Insp Needed
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Time Insp Needed ..
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Inspected By
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Permit No. 8112 Town of South Windsor, CT
Permit Date 11/14/2006
Expiration Date 12/14/2006 Drain Layer Permit
Descrip: INSTALL SANITARY LATERAL
Applicant
LC3oat Y;pn
Name KESSLER CONSTRUCTIO14 C� .
Ci AVE
Addr. 244 PROSPECT AVE: POAG M(�,EWB LIi�ESTXLES CENTERS
HARTFORD CT 061.06
Phone No. (860)286-0833
The Drain Layer assigned this"p�M has amid lxce'nses: ed by the
state and hereb a r:;,es<, o:'' y
Y J t „ .:the terms an co M1.11, on8»`s t:::;forth in the
attached 'Conditions" All 'wark' Sh"11y; <',3 %`' bda��e'wth To:
of South
Windsor standards, alY<<. OSHAeq'uiren ?tS, dxthe atde,cT:;;p:oditions.
Issued By ---- 91-i Tfb1e r✓�
Date Inspected
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: 2-1 - 3`P 1 b 6vf- Lot #
Street No. Street Name
Premises owned by:
Name of Firm:&Ls69 �r1i��li� e0` Phone: v�
Address of Firm: ,4����� �1
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 o e Estimated time for completion oe--IW l *P
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. v�Dd _. Only holders of P-1, P77 or W-9 licenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY(50DAYS 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. oeoocy,,�1092 -sue'
Signed- Print Name: �l�Lol
Licensed in Lay
Date: a�
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
SUBDIVISION:
NORTH ARROW
i
/ 4 I _�
--
5
4
i
CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUP SOR (PRINT)
244 /
STREET ADDRESS GNATURE
ti t4r'� C c /C�fo DATE
41
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE- NUMBER
WHITE TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER