HomeMy WebLinkAboutDrain Layers Permit 7 Chase Farm Road Permit .Date 09/23/ 1997 Drain Laver Permit
,,Expiration Date 10/23/ 1997
Descr i_p c LOT 1
App l i cant Locat. on
Name CERBER CONSTRUCTION CO Addr. 7 CHASE FARM RD
Addr . 616 DART HILL ROAD Owner CHASE ASSOC
VERNON CT 060€6
Phone No. (860 )875-6684 "
The Drain Layer assi°gned this perMi, has a °v,Vid license issued by the
state and hereby agrees 'to: al 1-'�,the ter ns an'd 'ca.rfd#1t oris set forth in the
attached 'Conditions' -.' ,All, work shall' be in a",Or #ance with Town of South
Windsor standards , a11 'OSHA requirements,";:and the" attached conditions .
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APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH W0YDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: �,,; s'r� {' Lot #
Street Now r et Name
Premises owned by:
�,
Name of Firm: ��.�- �'' ,�.. Phone:
Address o.f Firm:
TYPE OF WORK:
Lay House Drain , Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with ` -�
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 to the holder of Drain
layer's License No. a=+/_Cz -'Only holders of Pl, P7 & W9 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.
04
t,
Signed: .__�'_ f, Print Name
Licensed Drain Layer
Date: `,7- '