HomeMy WebLinkAboutDrain Layers Permit 75 Heritage Drive Permit No. 75— -r � Gont.jaictor J H 'ALA LER CON`.T (::0
Location 004-6' HE.RT I AGE:. L)R I v E Acd resy ib COMMERCE WAY
Type Work; ' raEv! SAIA I.-Al- «()'U'lH WINDSOR Ci 06074
Phone No. ( 860 )523-5252
Date Insp Needed Date Insp.
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Time I nsp Needed - -- ------- __ �.:_ T'i me Insp
Inspected By
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Permit No . ndsor , t
Permit Date 0 /0 3/ 1 998 Drain 1_ayor Perrni r
Epp i r.-aP on '0ate 04/0 '/1 998
Descr - p : PRORATE 20
:1pp 1 i -:an t; Lo( at;7 uri
Name J & H SLATER GONST CO Adds-: -6-C�HERTIAGE: DRIVE
Addr . 15 COMMERCE WA`r Owner f1Sh-f.FL.LCO INC .
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SOUTH WINDSOR CT 06 74
Phone No . (860)528-52521
The Grain Layer ass r fined this perms t has va fA d, f itcense i : sued by the
state and hereby agrees to,' al 4 the terms and clogdj ti-ons set:. forth in the
attached ' Conditions ' . A) V writ-k sha 1, ��':A n ac"cor dunce with Town of South
Windsor standards , a i i, OSHA r,eyu't remen;ts and the attached conditions.
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Issued By � ,t $ _
Date Inspected 3 �
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nspecte -�
�..n TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 3 d- gS
BUILDING ADDRESS Z- 17
STREET
SUBDIVISION:
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
Co7 5- m err P.{�G 2 G(/a
STREET ADDRESS SIGNATUR
,So v7- A/1,46 f 06 0 7 �/ �"' � -S=� DATE
TOWN STATE ZIP INSPECTED BY TOWN
no SZ. DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WIlVDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work 75- Lot # --7
Street No. Street Name
Premises owned b X
Name of Firm: 4"fy i�fc Phone:
Address of Firm: �E✓�
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 /wli / � the holder of Drain
layer's License No. 2-o77�% Only holders of P1, 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: Czi Print Name
Licensed Dr n Layer
Date: 6 3 IY5-