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HomeMy WebLinkAboutDrain Layers Permit 100 Cedar Avenue TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 7959 .00 i6ont.ra'ctor,ASPAZ2ARYN1:::__CONSTRUCTION Location L A FITNESS CPd(/i�� o PQ8T-C7FFIC"E..RD Type Work NEW SAN LAT R'F.z:E:T4p, CT> 0,6082.; Pli'on.e`No (860)745 5G88 Date Ins Needed p ------------- ---� D.�t TYrs .:: Time Insp Needed _____________ u_ T.ie Irish ' Inspected By �S : s Work in Progress DateJA I i 1 Permit No. 7959 Town of South Windsor, CT Permit Date 09/07/2005 Drain Layer Permit Expiration Date 10/07/2005 Descrip: CONNECTION FEE FOR LA° FITNESS` AND PERMIT`^FOR`;LATR:RAL Applicant Lo:Gia>t 'pn Name SPAZZARINI CONSTRUCTION A�dr T -AV TN Addr. 50 POST OFFICE RDoi Oulu i ENFIELD, ICT.::06082 Phone No. (860)745-5683 -:: The Drain Layer ass`3`gnedta:�s prinx has a tra1C� licss asued by the state and hereby agrees�to,all the terms ..and con Ita c'n sit =:forth in the i r. x:: T wn of South attached Conditions :; •A5.1 �nto�k`':sh'a�7'��zs�'`asz�" i�d,� � �. Windsor standards, a11,..OSHA �eq�}1rslit #Ats, a h attached .c©ncitions. ? >: Issued By TsEle ; ----- ------ --- ----------------- ti Date Inspected ________________�___ Ins'p'ec' "�'ti" 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: Lot # r Street No. Seet Noie /00 Aii✓P Premises owned by: ,�;,� 10 �aH������ Name of Firm: p Phone:- Flo f =s6't�3 Address.of Firm:_ 01 4 07 TYPE OF WORK: Lay House Drain Main Lay La;IZe�—PJIF-H—ome-Drain- Lay -for Commercial/Industnai'- Building 0 - MIFUS Connection will be made with Existing Water Supply: Public Water 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 tom,. the holder of Drain Layer's License No. _z,74 73 Only holders of P-I A 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. Signed:4ice— Print Name:n ain Layer Date: T* Standard Forms\Permits\APPLICAlION FOR DRAIN LAYERS PERMIT.doc rAvuAV;lANTi GROUP I@oo3 %j IT NN .:FEE; " ,atafi` 'C + g . , ; , , , ., ;' „ ; , CoOwy pua6it to your- "Ruesil C , l3bftm A)r,llhv LA Iftow w%Q SA31129. Ctaig por amPx- Alit[J"o 3G ssrc to 33,A; d 4 4, you vqm sty fa ex infora ador 01 1 21, -31 1 , r jrr w •� • � ■■■ ■■ ■ ■■ ■ ■■ ■ ! {L%EMM III _. Mr ■ ■ ■■■ im ■■ ■ mom ■ �■ ■■■■ ■■■ ■■ ■■■■ ■■■ ■■■ ■■ ■ ■■■ CONTRACTOR'SCONTRACTOR (PRINT) NAME OF .. s STREET bDRESS SIGi;m t r TELEPHONE WHITE - t CONTRACTOR YELLOW - CONSULTINGDEVELOPER