HomeMy WebLinkAboutDrain Layers Permit 68 Lavender Lane 750041
TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 08/14/07
GIS ID: 52600068 y.. FEE: 60.00
MUNIS APPLICATION# 200701278
EXPIRATION DATE
09/13/07
APPLICANT
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OCATI ON
NAME: JACQUES CONSTRUC. ION"(JT1 .gip.. RESS"-„- . $` AVE' ER LANE
ADDRESS: 67 RIDGE ROAD t,v
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SOUTH WINDSOR CT-.
'9-FL`LINTON ROAD
:w : 'I WII DSOR CT 06074
PHONE _ '
860 432-�823'"` ¢;
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SCRIPTION:
ON• NEW SE WE�i"
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THE DRAIN LAYER ASSIGNED TO THIS PERMIT I A A 7�IS I t1 j5 `s-THE STATE AND HEREBY AGREES
S TO ALL
THE TERMS AND CONDITIONS SET FORTH.III;L HE'> ETA _ .gNS';4! L WVyQR SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARD S AIL C} IA X; Np T-jibTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
8/14/2007 10:15 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
06 CONTRACTOR:__
- LOCATION:_ �-
TYPE OF WORK: e .o
DATE INSP NEEDED: DATE INSP: Z& v
INSPECTED BY: 8D
WORK IN /
PROGRESS: � rl�✓ n s "' s�'liC 3s � ,� d
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AS-BUILT:
INPUT: DATE: a 1
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: g' L �t�Kaii Lot #
Street No. Street Name
Premises owned by:..
Name of Firm: Phone: -.;k Sp
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 sb�Z
Existing Water Supply: Public Water__ Well
Proposed Start Date $ Estimated time for completion
ALL WORK TO BE IN CCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHAREQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to 1J'MTcg,. the holder of Drain
Layer's License No. JQ Pmy holders of P-1, P-7 or W-9 licenses
will be issued a permit. PERMIT WILL E&PIRE 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.
CBYD No.
Signed: Print Name: T o� A
icen Dr �-Layer
Date:
— --------- ---standard Form s\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc -
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS � �/f/ID��P '✓�1 � CDT 7
STREET
SUBDIVISION:
TNORTHARROW
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CONTRACTOR (PRINT) NAME F CO CTOR'S PERVISOR (PRINT)
STREET ADDRESS
� TORE
DATE
TOWN STATE zip BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YtLLOW - CONSULTING ENGINEER / DEVELOPER