HomeMy WebLinkAboutdrain layer permit 1511 Sullivan Avenue W TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No.
Location Contra<ct'or SICTh; a`"S:ERTIC
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Permit No. 8094
Permit Date 09/21/2006 Town of South Windsor, CT
Expiration Date 10/21/2006 Drain Layer Permit
Descrip: INSTALL SEW. LAT. & PUMFt::CHAM$'Ejky
Applicant
LoCdtion
Name SKIPS SEPTIC Y
k511 Addr 9ULLIVA
F A�TENUE
. 27 MUDDY BROOK RC�D a a
# k�� CTAGk a RO'C,E2 $. VIVIAN L
ELLINGTON GI,x06�393
Phone No. (860)875-2332tia
ytE£
The Drain Layer assig e ',th s er
state and herebya a*y' p zs �'f�lid lea ce�,st issued by the
gaes tox t � rs ane1tiari5 s a
attached 'Conditions,' , Yl Y s frh in the
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Windsor standards, �th Tows of South
a lar t7Hiatc s
k
'ach�d conditions.
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Issued By • "
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Date Inspected Y A F%ort ��
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: /SW SGc�._1v'l / �
Street No. Lot#
Street Name
Premises owned by: ;Z66 F 1Z� C' ,�/ N0l\(
Name of Firm: <P S �7S Z 3 j�Phone:
Address_of Firm: -0• Box 7-9 ,GWPY Izzoyk, E,�
TYPE OF WORK:
Lay House Drain X Repair House Drain '
Lay Main . ;
Lay Lateral'for Commercial/Industrial
Building of acres
Connection will be made with .5Cl/ 4-0 w►c
Existing Water Supply: Public Water Well
Proposed Start Date Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITN*TOWN.OF SOUTH WINDSOR STANDARDS ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to__ L�/ C F
Layer's License No. _ o��z the holder of Drain
will be issued.a Only holders of P-1, P-7 or W-9 licenses
ISSUANCE
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.
Town Street Excavation Permit No. Applicant has received
and/or ConnDOT Permit No.
CBYD No. Z (
Signed: - Print Name: ?7dTk GzJFJz- �
Liger) kniyer
Date: 2� 0
standard FOMIAPermits\APPLICA'TION FOR DRAIN LAYERS PERMIT.doc
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TOWN OF SOUTH WINDSOR
SANITARY . ISEWER LATERALFIELD LOCATION-:
DATE OF CONSTRUCTION: D (10
BUILDING ADDRESS
STREET . I` t SV'LLIUA&J� Ay'.
m SUBDIVISION: "
NORTH ARROW
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STREET ADDRESS' SIG
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TOWN - STATE ZIP INSPECTED BY TOWN
233 Z DATE
TELEPHONE NUMBER
WHITE - TOWN PINK.- CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER
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