HomeMy WebLinkAboutDrain Layers Permit 80 Chase Farm Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6577 Contractor UNITED PLUMBING & HEATING
Location 80 CHASE FARM RD. Address 29 BISSELL ST
Type Work NEW SAN LAT E . HARTFORD CT 06108
Phope �No. (860)289-9511
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APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: Lot #
jStreet No. Street Name
Premises owned by: -cgs •
Name of Firm: Phone: 9~�
Address of 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 -//-g?Estimated time for completion lc
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 1'-faA k Auv r c ' the holder of Drain
layer's License No. 0 0-?,0/3 3 'K. 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.
Signe Print Name va
Licensed Drain Layer
Date: