HomeMy WebLinkAboutDrain Layers Permit 21 Copper Ridge 750006 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 04/02/07
GIS ID:25300021 FEE: 60.00
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MUNIS APPLICATION# 200700355 `` :::><,:.k" '.., EXPIRATION DATE: 05/02/07
APPLICANT.....' ��:.. < „ _.. : d <I.00ATION
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NAME: J&H SLATER CONST CO =t LLG
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ADDRESS: 75 COMMERCE WAY.: ... - ..,IF. O INC
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4 T RD
SOUTH WINDSOR CT{YG 7 :::; ON 0 >:.0 :E LII�t
,� CJ�'HF�DSOR,CT 06074
PHONE 860-528-P2 2•--
WORK DESCRIPTION: INSTALL
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THE DRAIN LAYER ASSIGNED TO THIS P RM I.IIA;1S`A U f j I( SUED?i TITS SZATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH N; 11E. 1'JAd'. SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS, ISiI .RfX'A l .I�TI ':F1IE,ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
4/2/2007 10:16 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 7 S ®4 CONTRACTOR:
LOCATION:_ ADDRESS:
TYPE OF WORK: R� � -
DATE INSP NEEDED: DATE INSP: z d
INSPECTED BY:
WORK IN
PROGRESS: Cc Jv�� D , � ��d �" pvc
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APPLICATION FOR DRAIN LAYER PERMIT 75 �
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
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Location of proposed work: 2 �'�� ,L-t�-t , Lot #
Street No. Street Name
Premises owned by: k !r— � CCxJ
Name of Firm: J E= Phone: -Sz-SZ
Address of Firm: 7S aYtil,&E(U-�-E WAS
TYPE OF WORK:
Lay House Drain X ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water X Well
Proposed Start Date 161 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 m 5ukT&L the holder of Drain
Layer's License No. Z4�61( 1 cS4'L . 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 apo attached thereto. Applicant has received
Town Street Excavation Permit No. A- and/or ConnDOT Permit No.
CBYD No. 2- (:3(s (S q 1—
Signed: Print Name: J. �LPrTEJZ-
ensed Drain Layer
Date: TT7
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL TIELD LOCATION
DATE OF CONSTRUCTION: '` - L - 0 7
BUILDING ADDRESS ; �-� C`yw4tr lei
STREET p � , 1
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- SUBDIVISION-
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF G' NTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS - SIGNATURE
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TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER