HomeMy WebLinkAboutDrain Layers Permit 120 Pheasant Way 750028 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
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w DATE: 07/18/07 s "x
GIS ID: 71100120 �'` FEE: 60.00
MUNIS APPLICATION# 200701123 ' `%' >'` ' ` EXPIRATION DATE: 08/17/07
APPLICANT. LOCATION
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NAME: BARBER UTILITIES LL& RITE SANT W
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ADDRESS: P O BOX 331 � '�`�" -.. <. ,E
ELLINGTON,CT
060 ' `<', .:�. :•:; :.6A t&''NbTON RD
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PI WINDSOR,CT
06074
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PHONE 860-872-2-330iii �•.." ,.
WORK DESCRIPTION: NEW SEVhEY'L1L ;:,:F>;;:. ``: I( <<.<.
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THE DRAIN LAYER ASSIGNED TO THIS`P1RMIT', A:; 1I $Y]ED Y::TI E STATE AND HEREBY AGREES TO ALL
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THE TERMS AND CONDITIONS SET FOR'1`j IN�`Ii.: 1T3C� IS'.. t FtVT SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAT0S'-ALVt*;V'1.1 L�'TSy>t ND II 1`TACHED CONDITIONS. F
ISSUED DATEIN"SP'ECTED INSPECTED BY
7/18/2007 12:22 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.
CON I RAC i OR:
LOCATION: o V�/ / ADDRESS:
TYPE OF WORK:_
DATE INSP NEEDED: DATE INSP: '7 �°7
-INSPECTED BY:
WORK IN
PROGRESS:
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INPUT: C DATE:
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: /2d A1C"g5g-" bl" tot # �
Street No. Street Name
Premises owned hi q o�2
Name of Firm: I/M13� �/%� S ���- Phone: 860— 7 z-233 0
Address of Firm: 3 /0)AIV A-r— I-t- 404 ti
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
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Connection will be made with � P P�
------------ Existing Water Supply: Public Water Well
Proposed Start Date 743_0 7 Estimated time for completion / 4✓F-arc
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 VII-94 0C . yi? -17,6 S z-&c the-bolder of Drain
Layer's License No. Z-7 f33 SI( . Only holders of P-1 r 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 and attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No. 2 o0 7 Zq 018 q 3
Signed: Print Name: Z)/I-v1,9 6, 57 NS
Licensed Drain Layer
Date:
Standard FDrms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 7 6 +� /07
BUILDING ADDRESS Pic
STREET : -
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME CONTRACTO SUPERVISOR (PRINT)
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STREET ADDRESS S NATURE
L LiA)c,7aaU �?- �60 Z� �!�-.��� 7/2�la„fATE
TOWN____ _ STATE ZIP INSPECTED BY TOWN
8 6 _ s 72 —23 3 0 DATE
TELEPHONE NUMBER
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