Loading...
HomeMy WebLinkAboutDrain Layers Permit 91 Birch Hill Drive APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $60.00 Location of proposed work: l � ���y, , Lot # Street No. . Street Name Premises owned by: a Name of Firm: yro�� S z kph one: Ye6 Address.of Firm: o5: C�;/t;�� TYPE OF WORK: Lay House Drain Repair House Drain Lay Main - ' Lay:Lateral for Commercial/Industrial Building of acres Connection will be made with Existing Water Supply: Public Water -, ._. Well_______-- Proposed Start Date y .2.8- 06 Estimated time for completion ALL WORK TO BE IN ACCORDANCE WI TH'TOWN OF SOUTH WINDSOR STANDARDS ALL OSHA.REQUIREMENTS AND CONDITIONS ATTACHED TO THE PEPERMIT , Permit is to be issued to �.os ,r / Layer's License No. 7 the holder of Drain will be issued.a Only holders of P-1. P-7 or W 9 licenses permit, PERMIT WILL EXPIRE THIRTY(30)`DAYS AFTER DATE OF ISSUANCE. The undersigned pram (.aver. hereby agrees to -and conditions set forfih in the 9 all the terms Town Street Excavation PermitNo�t and attached thereto. Applicant has received and/or ConnDOT Permit No. CBYD No. c,2©O6' 160. Y�7 Signed: . icensed Drain Layer t Name: Date: -y Z,�6 C;�.©®A-, Standard Forms\PerM1ts\APPUCATI0N FOR DRAIN LAYERS PERmrndoc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD , LOCATION, DATE• OF CONSTRUCTION: `fl BUILDING ADDRESS STREET SUBDIVISION: A D 3s-' 36 c feoq ®vf NORTH ARROW ° r 1 4- µ _ A 4- � � y CONTRACTOR (PRINT) NAME OF C RACTOR'S SUPERVIS (PRINT) STREET ADDRESS SIGNATU E C f agV oC'/D$' DATE TOWN STATE ZIP INSPE D BY TOWN . � y DATE TELEPWNE NUMBER r TOE PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER DEVELOPER TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 8047 Contpa•&tor VIOL2TT'Ea,.SILVESTER & SONS Location ± 6 $, IVE 2 cTc�res.s..�, :65 Ci:�R-R STREET Type Work NEW SAN LAT EAST HARTF�3RI� &T 0 610 8 �n { ^ Phony Np (864)289 36.6 - : ' j b✓. Date Insp Needed _`/�Z✓ �p _ Date: Tnsp _ 7 _ Time Insp Needed T`�m ____________ e Ins � a Inspected By r . Work in Progress , I s _ ;f t °` Lax Dr , '` AT S.9 Permit No. 8047 Town of South Windsor, CT Permit Date 04/26/2006 Drain Layer Permit Expiration Date O5/26/2006 Descrip: CH38865 FOR PERMIT A Applicant Locat�:on Name VIOLETTE SILVESTO SONS Acgl pQ:91 $IRCH HILL DRIVE Addr. 65 CHERRY STREE F, T Otnex JONES It1NTL F & ROBYN J „.. t EAST HARTFORD CT...01¢8.._ Phone No. (860)289-3466 The Drain Layer assY:gnec3 CYi�s i73 has arl1d l.z en�e i.s:,sUed by the state and hereby agiees 'tU ail the terms and corTdion set;> orh in the attached 'Conditionst All wdk sha7 ;zrs ad 'ordane GYltti Town of South Windsor standards, all OSHA equir fn+lts, �tt1cA tkie attaelied.::go.n-ditions. Issued By --✓ r{ ( /1/` it1s ��.n `.uv. Date Inspected �'j �� p -------- ------------ IiSSe'C°t'e'3'`SY ---