HomeMy WebLinkAboutdrain layer permit 1527 Sullivan Avenue TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No.
Location LLI - „ Con:trActor VIOL9TTFi SILVESTER & SONS tY
A ENUE Address 65
Type Work N LAT .Q:.
NW SA RY S3REET
SST H�RT&ORD CT 06108 1�
Pho;3$ No .. 2$9 �- :
Date Insp Needed
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Time Insp Needed
Inspected By
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Permit No. 7658 Town of South Windsor, CT
Permit Date 09/09/2003 Drain Layer Permit
Expiration Date 10/09/2003
Descrip:
Applicant
p cant
P t.
I,... a ,zon
Name VIOLETTE SILVESTO�R ,& SONS' t cd �� StT.TaI VAIQ`•AV NUE
Addr. 65 CHERRY STREET QsN17er KOCHA,I�&Xl CRAIG ;;.LYNN M
r.
EAST HARTFORD GT 0610$ „
Phone No. (860)289-3k66: '
The Drain Layer as$igne�3 ,this gorz,t ha a Y���a d �'7 Cense a ssued by the
state and hereby agxes to :1 the terms and condit�o ,se<
t fo. th in the
attached Conditions All.. work sxa''7r' Cbordasice �th Tpwn of South
Windsor standards, al;l OSHA< 'he arr-a'che4-.''conditions.
Issued By
Date Inspected Ins ' 'c't"ed By
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: IS-2 7 Su 1�� � Lot #
Street No. Street Name
Premises owned by: C'Y�1 c) cGi a J,
Name of Firm:_ 5r*1 ycs��r d-SoA,S fp)c, Phone: -2 R 7-3 166
Address.of Firm:
TYPE OF WORK:
Lay House Drain_; Repair House Drain
Lay Main ; Lay Lateraf for Commercial/Industrial
Building of acres
Connection will be made with �r_ c� /V C
Existing Water Supply: Public Water_ Well
Proposed Start Date 9 9 03 Estimated time for completion a day's
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 '_D a the holder of Drain
Layer's License No. 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. a o 033 S0 z� ?/Cl
Signed: Print Name:`
Licensed Drain Layer
Date:_ q�p�3
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 7-
BUILDING ADDRESS I7 sv�w�Iry
STREET
SUBDIVISION:
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGRvt
j � e� DATE
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TOWN STATE ZIP INSPECTED BY TOWN
9-0 cT,3 Yl 6 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER