HomeMy WebLinkAboutDrain Layers Permit 60 Heritage Drive Permit No. 677 -1 Contractor J & H SLATER C:ONST CO
Loeat'ion 0060 HERTIAGE DRIVE Address 75 COMMERCE WAY
Type .Work NEW SAN LAT SOUTH WINDSOR CT 06074
t t Phone No . ( 860 )528-5262
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Permit No, 6771 Town of South Windsor, t.�T
Dcrmit rlatn Ti 11QiQ =iR „ r, a,rn. i7 �a-•
Exp 1 r,at^ion Date 04/ 18/ 1 9�,t
Descrip:
App 1 i cant L..ocat i on
Natile j & H SLATER CONST CO Addt 0060 FIERIIAGE DRIVE
Addr . 75 COMMERCE WAY Owrter RSK-r.FLLCO INC.
SOUTH WINDSOR CT 06074
Phone No. (860 )528-5252
The Drain Layer assfgned, thi petm,1t 'f�as '� ii�t,>t C�, license issued by the
state and hereby agrees to aii the terms and 0ohddAibns set forth in the
attached 'Conditions ' .' A 1 ,."Wor#� ai-va1 1. ;be,: in acc;Qn dance, with Town of South
Windsor standards , all ``OSH#A ,:re i i r ement.s, and" 'r,he--a�tt4ched conditions.
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Issued By --�-a T i t Is
Date Inspected _ 2��Z� `�5 . w °`-1n0Per'ted
Permit No. 67i' 1 Town of South Windsor , CT
Permit Date 03/ 1 9/ 1958 �?��ce � ��t - Dr,a i n layer
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 3 "�7_ '
BUILDING ADDRESS
STREET
+ SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OFCONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATU
SOU74 w o&1JoA-- C7- 7 41 � Z3 qg DATE
TOWN STATE ZIP INSPEC D BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
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: (� �c12 i 1 '��� � 12- Lot # r I
Street No. Street Name
Premises owned by:
Name of Firm: �� t ( E 1-i Z.�� ( i, Phone:
Address of Firm:
TYPE OF WORK:
Lay House Drain �- _; Repair House Drain ;
Lay Main ; Lay Lateral for CommerciaVIndus trial
Building of acres -
Cr
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Connection will be made with V<
Proposed Start Date,�-ld-`1 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 }i c (,(i. j Cr1 i =i2___ the holder of Drain
layer's License No. �' (7<<`j 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.
Signed: �� i ;/?�, Print Name
Licensed Drain Layer
Date: "- ��